title: Global cardiovascular protection in chronic kidney disease.
abstract: The development and progression of cardiovascular disease (CVD) and renal disorders are very closely related. In patients with chronic kidney disease (CKD), therapies proven to protect the cardiovascular and renal systems simultaneously are generally used only at low doses or not at all. In particular, patients with CKD who receive angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, or mineralocorticoid-receptor antagonists (MRAs) often do not experience complete blockade of the renin-angiotensin-aldosterone system, primarily owing to the risk of hyperkalaemia. In this Review, we provide an overview of the available treatments required for adequate cardiorenal protection in patients with CKD. Drugs such as β-blockers that interfere with renin secretion will be discussed, in addition to agents that can prevent hyperkalaemia, such as potassium binders and nonsteroidal MRAs. Furthermore, the current literature on the role of statins, in addition to new compounds and dosing recommendations for the treatment of patients with CKD will also be reviewed. Further studies with these new compounds and doses are needed to ascertain whether these approaches can improve the long-term cardiovascular and renal prognosis in patients with CKD.
authors.affiliation: Unidad de Hipertensión and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain.|Instituto Pluridisciplinar and Facultad de Farmacia, Universidad Complutense de Madrid, Paseo Juan XXIII 1, 28040 Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Ruiz-Hurtado
authors.affiliation: Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Sarafidis
authors.affiliation: Unidad de Hipertensión and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain.|Instituto Pluridisciplinar and Facultad de Farmacia, Universidad Complutense de Madrid, Paseo Juan XXIII 1, 28040 Madrid, Spain.
authors.forename: María S
authors.initials: MS
authors.lastname: Fernández-Alfonso
authors.affiliation: Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois, Chemin des Boveresses 155, 1066 Epalinges, Switzerland.
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.affiliation: Unidad de Hipertensión and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain.|Departamento de Salud Pública y Medicina Preventiva, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28049 Madrid, Spain.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
mesh_terms: D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D012076:Renal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D012076:Renal Agents