title: Reducing cardiovascular mortality in chronic kidney disease: something borrowed, something new.
abstract: CLINICAL VIGNETTE: A 48-year-old man with chronic kidney disease stage five due to type II diabetes mellitus and hypertension was referred for hemodialysis initiation. His physical exam showed a blood pressure of 150/80, normal fundi, a positive fourth heart sound (S4), and trace pedal edema. Moderate aortic calcification was present on prior chest X-ray. The ECG showed left ventricle hypertrophy by voltage and slight prolongation of the QT interval. Medications included chlorthalidone, amlodipine, carvedilol, cholecalciferol, erythropoietin, and a phosphate binder. What additional therapy should be initiated to reduce vascular calcifications and cardiovascular mortality?
authors.affiliation: University of Tennessee Health Science Center, 956 Court Ave., Suite B226, Memphis, Tennessee, USA. dquarles@uthsc.edu
authors.forename: L Darryl
authors.initials: LD
authors.lastname: Quarles
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000188:drug therapy*; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D057170:Translational Research, Biomedical
chemical_list: D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23