Cardiovascular disease and chronic kidney disease: Insights and an update

• Published in: The American heart journal Vol. 148; no. 2; pp. 230 - 242
• Main Authors: Best, Patricia J.M., Reddan, Donal N., Berger, Peter B., Szczech, Lynda A., McCullough, Peter A., Califf, Robert M.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2004; Elsevier; Elsevier Limited
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - therapy; Chronic Disease; Erythropoietin - therapeutic use; Glomerular Filtration Rate; Heart attacks; Humans; Hyperhomocysteinemia - complications; Kidney Diseases - classification; Kidney Diseases - complications; Kidney Diseases - drug therapy; Kidney Diseases - epidemiology; Medical sciences; Medical treatment; Mortality; Myocardial Revascularization; Oxidative Stress; Recombinant Proteins; Risk Factors; Rodents; United States - epidemiology; Womens health; United States; United States > US; Kidney disease; Cardiovascular disease; Chronic; Urinary system disease; Heart disease
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2004.04.011

Despite the high prevalence and significant morbidity and mortality rates of chronic kidney disease (CKD) related to cardiovascular disease, it remains vastly understudied. Most of the current practice recommendations come from small under-powered prospective studies, retrospective reviews, and assuming patients with CKD will similarly benefit from medications and treatments as patients with normal renal function. In addition, because of the previous lack of a consistent definition of CKD and how to measure renal function, definitions of the degree of renal dysfunction have varied widely and compounded the confusion of these data. Remarkably, despite patients with CKD representing the group at highest risk from cardiovascular complications, even greater than patients with diabetes mellitus, there has been a systematic exclusion of patients with CKD from therapeutic trials. This review outlines our current understanding of CKD as a cardiovascular risk factor, treatment options, and the future directions that are needed to treat cardiovascular disease in patients with CKD.