title: Management of ischemic heart disease in patients with chronic kidney disease.
abstract: Patients with chronic kidney disease (CKD) and ischemic heart disease (IHD) have strikingly high mortality rates. In the general population, there has been a reduction in the mortality and morbidity rates for IHD through the implementation of effective risk-factor-reduction programs and better interventions for patients with established IHD. No such trend has been observed in patients with end-stage kidney disease. This review article addresses the following topics: (i) epidemiology, pathogenesis, clinical CKD patients with IHD; (ii) diagnostic modalities for IHD and their limitation in CKD patients; (iii) medical treatment options and revascularization strategies for these high-risk patients; and (iv) optimal cardiovascular risk management. Generally, in CKD patients with IHD an aggressive approach to IHD is warranted, a low threshold for diagnostic testing should be employed, and awaiting a clinical trial targeting these patients they should be considered for all proven strategies to improve outcomes.
authors.affiliation: Department of Medicine, Division of Nephrology, National University of Ireland, Galway, Ireland.
authors.forename: Arif
authors.initials: A
authors.lastname: Mutwali
authors.forename: Liam G
authors.initials: LG
authors.lastname: Glynn
authors.forename: Donal
authors.initials: D
authors.lastname: Reddan
mesh_terms: D002908:Chronic Disease; D002986:Clinical Trials as Topic; D017023:Coronary Angiography / Q000379:methods; D004562:Electrocardiography; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors