Cardiovascular disease in chronic kidney disease

Abstract

Chronic kidney disease (CKD) is emerging health problem with prevalence of approximately 10% in general population. The incidence and prevalence of cardiovascular disease (CVD) is high in CKD patients, approaching >50% in patients in advance CKD. CVD outcomes are worse in presence of CKD suggesting different pathophysiology compared to general population. Patients with CKD are at increased risk of both atherosclerotic and structural heart disease, stroke and peripheral vascular disease. Congestive heart failure is most common cardiac condition. The increased incidence of CVD is attributed to presence of both traditional and kidney specific risk factors. The kidney specific risk factors include albuminuria, inflammation, hyperparathyroidism, altered calcium phosphate metabolism, homocysteine level and recently recognized coronary artery calcification gene. The preventive and therapeutic strategies for CVD applied to general population are also applicable in patients with CKD but with poor outcomes. The understanding of pathophysiology may provide better insight to develop methods with favorable outcomes in this unique patient population.