Cardiovascular disease in chronic kidney disease.
People with chronic kidney disease carry a markedly increased risk of cardiovascular disease — coronary artery disease, stroke, heart failure, arrhythmias and sudden cardiac death — and the coexistence of both conditions substantially worsens prognosis.
Background
Individuals with chronic kidney disease (CKD) show an increased risk for developing cardiovascular disease (CVD), manifesting as coronary artery disease, stroke, heart failure, arrhythmias and sudden cardiac death. When CVD and CKD are both present, the combination has a major impact on patient prognosis.
Study design
This is a State-of-the-Art Review in the European Heart Journal synthesising the current understanding of the pathophysiological link between cardiovascular disease and chronic kidney disease, together with its clinical implications and the challenges of treating affected patients.
Key findings
The CKD–CVD association likely reflects several overlapping pathophysiological mechanisms. These include shared risk factors such as diabetes and hypertension, alongside CKD-related contributors including inflammation, anaemia, volume overload and the accumulation of uraemic toxins. Because of this, identifying and characterising CKD is described as crucial for appropriate cardiovascular risk prediction.
Clinical implications
Accurate CVD risk prediction in this population depends on recognising and characterising the patient's kidney disease. Mitigating cardiovascular risk in patients with CKD mandates a multidisciplinary approach involving cardiologists, nephrologists and other health care professionals working together.
Category
Research
Source
Eur Heart J
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