The renal patient with cardiovascular disease--no longer a simple plumbing problem.
The clinical syndrome of chronic kidney disease (CKD) with coronary artery disease (CAD) is a clinical challenge. The risk of cardiovascular disease in patients with renal impairment appears to be far greater than in the general population. Despite the high prevalence of CKD related to cardiovascular disease (CVD), it remains understudied. Most of the current research comes from small community-based studies and retrospective reviews, assuming that patients with CKD will similarly benefit from treatments as patients with normal renal function. Most of the current clinical trials have excluded patients with CKD even though they represent a group of people at high risk for cardiovascular (CV) complications. CKD is associated with adverse CV outcomes and higher mortality even after adjustment for conventional risk factors. Declining renal function portends increasing CV risk and may be explained by several other factors that are being investigated, including inflammation, decreased vascular compliance, homocysteine, albuminuria and dyslipidemia. In addition, there is a lack of appropriate intervention in patients with CKD, despite established awareness of their high cardiovascular risk.
Tunuguntla
Anuradha
A
Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA.
Yerra
Lakshminarayan
L
D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy