title: Chronic kidney disease, dyslipidemia, and atherosclerosis.
abstract: Patients with chronic kidney disease (CKD) are at an increased risk not only for end-stage kidney disease (ESKD) but also for cardiovascular disease (CVD). In this review article, we summarize the current evidence of CKD as a high-risk condition for CVD based on reports from Japan and other countries to draw attention to the close clinical association between CKD and CVD. Several epidemiologic studies have shown that the presence of CKD and reduced renal function are independent predictors of CVD also in Japan. According to a post-hoc analysis of CASE-J, the power of CKD as a predictor of CVD is as strong as diabetes mellitus and a previous history of ischemic heart disease. CKD worsens classical risk factors including hypertension and dyslipidemia, and dyslipidemia is associated with increased thickness and stiffness of large arteries independent of major confounders. A post-hoc analysis of MEGA indicates that lipid-lowering therapy with statins reduces the risk of CVD, and that it appears to be more efficacious in patients with than without CKD. These reports from Japan and other countries suggest that CKD should be regarded as a high-risk condition comparable to diabetes mellitus, and that strict control of dyslipidemia would be beneficial in preventing CVD, at least early stages of CKD.
authors.affiliation: Department of Geriatrics and Vascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Osaka, Japan. t-shoji@med.osaka-cu.ac.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shoji
authors.forename: Takaaki
authors.initials: T
authors.lastname: Abe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuo
authors.forename: Genshi
authors.initials: G
authors.lastname: Egusa
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Kashihara
authors.forename: Kohji
authors.initials: K
authors.lastname: Shirai
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
mesh_terms: D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D012307:Risk Factors