Chronic kidney disease and cardiovascular risk |
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Affiliation: | 1. Department of Internal Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA;2. Division of Nephrology, University of Missouri School of Medicine, Columbia, Missouri, USA;1. Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA;2. Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA;3. The Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, China;4. South Texas Veterans Health Care System, San Antonio, TX 78229, USA;1. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan;3. Ohta Nishinouchi Hospital, Fukushima, Japan;4. Department of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan;1. Sydney School of Public Health, University of Sydney, NSW, Australia;2. Centre for Transplant and Renal research, Westmead Hospital, Westmead, NSW, Australia;3. Renal Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium;4. NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia;5. Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK |
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Abstract: | Chronic kidney disease (CKD) is a global public health concern, and there is emerging a strong relationship between CKD and increased cardiovascular disease (CVD) risk. CKD in the presence of other co-morbidities such as type 2 diabetes mellitus (T2DM) and hypertension (HTN) can lead to early progression to end-stage renal disease (ESRD/stage V CKD) and confer a greater risk for CVD morbidity and mortality. CVD events are the leading cause of premature death in patients with CKD, even before their progression to ESRD, with the rate of CVD progression being twice as common compared with the general population. The higher mortality from CVD persists even after adjusting for most of the traditional risk factors, suggesting the possible contributions of uremia-related, nontraditional risk factors. This has led to the current understanding that the pathophysiology of CVD in CKD involves a complex interplay of both the traditional as well as nontraditional, uremia-related risk factors. This review will elaborate on the pathophysiology of CVD in CKD and will discuss the role of microalbuminuria (MAU)-proteinuria as a potential diagnostic and prognostic tool for CVD in CKD risk assessment. |
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