Coronary artery disease and peripheral vascular disease in chronic kidney disease: an epidemiological perspective.
The enormous burden of CAD and PVD inpatients who have CKD contributes substantially to increased morbidity and mortality. The increased risk of vascular disease observed in CKD patients is likely to be multifactorial, with contributions from traditional and nontraditional cardiovascular factors. Given the overwhelming evidence on the known benefits of cardioprotective medications, their underuse remains puzzling in a population at enormous risk. During the past 5 years, the research community and national interest groups have made significant progress in organizing a concerted approach to improve the management of patients who have CKD and vascular disease. Much work remains to be done. The development of national guidelines in the management of these patients at high risk for future cardiovascular events will be a welcome step. The evaluation of multitargeted interventions for reduction of cardiovascular risk through randomized clinical trials is desperately needed. Finally, the low use of known cardioprotective strategies in this high-risk group is a serious issue and warrants immediate attention at local and national levels.
Stack
Austin G
AG
Regional Kidney Centre, Department of Medicine, Floor D, Letterkenny General Hospital, County Donegal, Ireland, and Internal Medicine, University of Texas Health Science Center, 6431 Fanin Street, Houston, TX 77030, USA. Austin.Stack@mailb.hse.ie
D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D017281:Cost of Illness; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000401:mortality; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome