Mechanisms, Risk and Treatment
A strong relationship between chronic kidney disease (CKD) and accelerated cardiovascular disease, defined as the cardiorenal syndrome, is well documented, whether the initial event is in the kidney or in the heart. In the kidney context, mechanisms that link CKD and cardiovascular disease (CVD) involve both conventional and CKD (uremia)-related CVD risk factors. Several pathophysiologic processes...
Many national registries and epidemiological observations have revealed a strong correlation between morbidity and mortality of patients with cardiovascular disease and kidney dysfunction. In patients with heart failure, renal dysfunction is highly prevalent. Even mild to moderate renal dysfunction in patients with congestive heart failure, i.e., cardiorenal syndrome, leads to significant increase...
Atherosclerosis underlies the vast majority of vascular conditions that are a leading cause of death and serious morbidity or disabilities worldwide. Cardiovascular events rarely occur in patients without underlying disease; rather, they typically take place as the final stage of a pathophysiological process that results in progressive vascular damage, including vital organ damage—specifically, the...
Chronic kidney disease (CKD) is widely recognized as a public health problem. In this chapter, we review the basis for definition and classification of CKD as outlined in the National Kidney Foundation’s Kidney Disease Outcome Quality Initiative (K/DOQI). We also review the principles of screening and their applicability to CKD.
Cardiovascular disease remains the leading cause of morbidity and mortality in chronic kidney disease (CKD), and there is an urgent need to develop novel therapeutic strategies to reduce this excessive risk. In the context of uremia, this has been problematic, as the extremely high cardiovascular disease (CVD) risk seems to be the result of a complex interplay between a vast number of traditional,...
Excretion of albumin in the urine is highly variable, ranging from nondetectable quantities to grams. Increased levels of albuminuria are highly prevalent in healthy individuals and even more so in hypertensive and diabetic populations. The variable excretion of albumin in the urine is related to the risk for the individual to develop cardiovascular disease (CVD): absence or very low levels of albuminuria...
In the early 1960s, microalbuminuria was noted as a predictor of nephropathy and higher cardiovascular risk in patients with type 1 diabetes mellitus. Over the past four decades, however, the epidemiological evidence has become far stronger, implicating it as a cardiovascular risk marker than a risk factor associated with nephropathy. Microalbuminuria is also a marker of endothelial dysfunction, increased...
Cardiometabolic syndrome is a common condition that is increasing in prevalence in the USA and developing nations. Epidemiological studies indicate a strong association between cardiometabolic syndrome and subsequent risks for diabetes and cardiovascular events. Accumulating evidence suggests it may also be a risk factor for incident chronic kidney disease (CKD) and cardiovascular events in individuals...
Diabetes mellitus is a well established risk factor for cardiovascular diseases (CVD). In addition, a significant proportion of diabetic patients go on to develop nephropathy. Moreover, the presence of nephropathy further increases the risk of CVD in patients with all stages of diabetic nephropathy, including microalbuminuria, macroalbuminuria, and renal failure. The fibrogenic cytokine transforming...
After demonstration of a positive correlation between sodium intake and arterial pressure in large population studies, the effect of rather short-term reduction in sodium intake demonstrated the efficacy of this nonpharmacological therapy. In addition, a positive relationship between urinary sodium (the most reliable estimate of salt intake) and left ventricular mass was found in normotensive and...