Prevention of cardiovascular disease in chronic kidney disease patients

Seminars in Nephrology
Christoph Wanner

Abstract

Therapeutic strategies to prevent cardiovascular disease are based on the ability of the intervention to reduce specific risk factors and subsequent end-organ damage, implying that these factors are causally involved in the pathogenesis of the disease. In subjects with normal kidney function, the control of classic, Framingham-type, risk factors (blood pressure, glycemia, lipids, smoking) reduces impressively the burden of cardiovascular disease. In chronic kidney disease (CKD), prevention is based on similar strategies in general and on reduction of proteinuria (blockade of the renin-angiotensin-aldosterone system [RAAS], salt restriction) in particular. Although several nontraditional risk factors are recognized already in early stages of CKD (stages 1 and 2), they become more prominent in stages 3 to 5, most likely responsible for a different pathology. In fact, cardiovascular and all-cause mortality increase dramatically from CKD stage 3b (glomerular filtration rate < 45 mL/min/1.72 m2) to stage 5, and the pattern of cardiac and vascular damage changes profoundly. It appears that arteriosclerosis is recognized more often than atherosclerosis, and left ventricular hypertrophy or cardiac fibrosis is prominent. Randomized cont...Continue Reading

References

Jan 1, 1977·Kidney International·M L SanfelippoG M Reaven
Jul 1, 1993·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M P O'DonnellW F Keane
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R N FoleyM J Sarnak
Jan 5, 2000·Journal of the American Society of Nephrology : JASN·Florian KronenbergArnold VON Eckardstein
Jan 29, 2000·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·U SchwarzK Amann
Apr 16, 2003·Kidney International. Supplement·Colin Baigent, Martin Landry
May 14, 2003·Journal of the American College of Cardiology·Gennaro CiceRaffaele Calabrò
Jun 20, 2003·Lancet·Hallvard HoldaasUNKNOWN Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators
Jan 9, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Robert FathiThomas H Marwick
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu
Jun 3, 2005·Journal of the American Society of Nephrology : JASN·Danilo FliserEberhard Ritz
Jul 22, 2005·The New England Journal of Medicine·Christoph WannerUNKNOWN German Diabetes and Dialysis Study Investigators
Oct 28, 2005·Journal of the American Society of Nephrology : JASN·Marcello TonelliGary Curhan
Nov 24, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H HoldaasUNKNOWN Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators
Dec 31, 2005·Journal of the American Society of Nephrology : JASN·Eva BoesFlorian Kronenberg
Jun 10, 2006·Journal of the American Society of Nephrology : JASN·Sabrina SandhuMarcello Tonelli
Dec 23, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Marcello Tonelli
Dec 23, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Amanda D HyrePaul Muntner
May 5, 2007·Clinical Chemistry·Katharina-Susanne SpanausUNKNOWN Mild-to-Moderate Kidney Disease Study Group
Jul 28, 2007·Journal of the American Society of Nephrology : JASN·Danilo FliserPeter Riegler
Aug 3, 2007·Kidney & Blood Pressure Research·Bengt FellströmUNKNOWN AURORA Study Group
Sep 1, 2007·Stroke; a Journal of Cerebral Circulation·Furio ColivicchiCarlo Caltagirone
Sep 13, 2007·JAMA : the Journal of the American Medical Association·Rex L JamisonUNKNOWN Veterans Affairs Site Investigators
Nov 7, 2007·The New England Journal of Medicine·John KjekshusUNKNOWN CORONA Group
Jan 5, 2008·International Journal of Clinical Practice·G Jackson
Mar 29, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Eberhard Ritz, Christoph Wanner
Jul 17, 2008·Seminars in Dialysis·Charles A HerzogRod Passman
Jul 17, 2008·Seminars in Dialysis·Marie-Luise Gross, Eberhard Ritz

❮ Previous
Next ❯

Citations

Mar 18, 2015·Cardiovascular Drugs and Therapy·Sauri Hernández-ReséndizCecilia Zazueta
Mar 20, 2010·Current Opinion in Pediatrics

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.