The link between chronic kidney disease and cardiovascular disease

Sarmad Said, German T Hernandez, Sarmad Said, German T Hernandez

Abstract

Context: It is well known that patients with chronic kidney disease (CKD) have a strong risk of cardiovascular disease (CVD). However, the excess risk of cardiovascular disease in patients with CKD is only partially explained by the presence of traditional risk factors, such as hypertension and diabetes mellitus.

Evidence acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched.

Results: Chronic kidney disease even in its early stages can cause hypertension and potentiate the risk for cardiovascular disease. However, the practice of intensive blood pressure lowering was criticized in recent systematic reviews. Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mmHg as recommended in the guidelines improves clinical outcomes more than a target of less than 140/90 mmHg in adults with CKD.

Conclusions: The association between CKD and CVD has been extensively documented in the literature. Both CKD and CVD share common traditional risk factors, such as smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. However, cardiovascular disease remains often underdiagnosed und undertreated in patients with CKD. It is imperative that as clinicians, we recognize that patients with CKD are a group at high risk for developing CVD and cardiovascular events. Additional studies devoted to further understand the risk factors for CVD in patients with CKD are necessary to develop and institute preventative and treatment strategies to reduce the high morbidity and mortality in patients with CKD.

Keywords: Cardiovascular disease; Chronic kidney disease; Diabetes mellitus; Hypertension.

References

    1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–305.
    1. Bright R. Cases and observations illustrative of renal disease accompanied with the secretion of albuminous urine. Guy’s Hospital Trans. 1836;1:338–379.
    1. Gansevoort RT, Correa-Rotter R, Hemmelgarn BR, Jafar TH, Heerspink HJ, Mann JF. et al. Chronic kidney disease and cardiovascular risk:epidemiology, mechanisms, and prevention. Lancet. 2013;382:339–52.
    1. Eckardt KU, Coresh J, Devuyst O, Johnson RJ, Köttgen A, Levey AS. et al. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013;382(9887):158–69.
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Work Group. KDIGO clinical practice guideline for evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–163.
    1. Chronic Kidney Disease Prognosis Consortium1. Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS. et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073–81.
    1. van der Velde M, Matsushita K, Coresh J, Astor BC, Woodward M, Levey A. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortalityA collaborative meta-analysis of high-risk population cohorts. Kidney Int. 2011;79:1341–52.
    1. Kottgen A, Russell SD, Loehr LR, Crainiceanu CM, Rosamond WD, Chang PP. et al. Reduced kidney function as a risk factor for incident heart failure: the Atherosclerosis Risk In Communities (ARIC) study. J Am SocNephrol. 2007;18:1307–15.
    1. Abramson JL, Jurkovitz CT, Vaccarino V, Weintraub WS, McClellan W. Chronic kidney disease, anemia, and incident stroke in a middle-aged, community-based population: the ARIC study. Kidney Int. 2003;64:610–15.
    1. Wattanakit K, Folsom AR, Selvin E, Coresh J, Hirsch AT, Weatherley BD. Kidney function and risk of peripheral arterial disease: results from the Atherosclerosis Risk In Communities (ARIC) study. J Am Soc Nephrol. 2007;18:629–36.
    1. Astor BC, Coresh J, Heiss G, Pettitt D, Sarnak MJ. Kidney function and anemia as risk factors for coronary heart disease and mortality: the Atherosclerosis Risk In Communities (ARIC) study. Am Heart J. 2006;151:492–500.
    1. Alonso A, Lopez FL, Matsushita K, Loehr LR, Agarwal SK, Chen LY. et al. Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk In Communities (ARIC) study. Circulation. 2011;123:2946–53.
    1. Fox CS, Matsushita K, Woodward M, Bilo HJ, Chalmers J, Heerspink HJ. et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: A meta-analysis of 1 024 977 individuals. Lancet. 2012;380:1662–73.
    1. Mahmoodi BK, Matsushita K, Woodward M, Blankestijn PJ, Cirillo M, Ohkubo T. et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: a meta-analysis. Lancet. 380:1649–61.
    1. Wen CP, Cheng TYD, Tsai MK. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet. 2008;371:2173–82.
    1. Hemmelgarn BR, Clement F, Manns BJ, Klarenbach S, James MT, Ravani P. et al. Overview of the Alberta Kidney Disease Network. BMC Nephrol. 2009;10:30.
    1. Franco OH, Steyerberg EW, Hu FB, Mackenbach J, Nusselder W. Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease. Arch Intern Med. 2007;167:1145–51.
    1. Franco OH, Peeters A, Bonneux L, De Laet C. Blood pressure in adulthood and life expectancy with cardiovascular disease in men and women: life course analysis. Hypertension. 2005;46:280–86.
    1. Upadhyay A, Earley A, Haynes SM, Uhlig K. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med. 2011;154:541–8.
    1. Jicheng LV, Ehteshami P, Sarnak MJ, Tighiouart H, Jun M, Ninomiya T. et al. Effects of intensive blood pressure lowering on the progression of chronic kidney disease: a systematic review and meta-analysis. CMAJ. 2013;185(11):949–57.
    1. Kokubo Y, Nakamura S, Okamura T, Yoshimasa Y, Makino H, Watanabe M. et al. Relationship between blood pressure category and incidence of stroke and myocardial infarction in an urban Japanese population with and without chronic kidney disease: the SUITA study. Stroke. 2009;40:2674–79.
    1. Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent LVH in the predialysis population: Identifying opportunities for intervention. Am J Kidney Dis. 1996;27:347–54.
    1. Drechsler C, Krane V, Winkler K, Dekker VW, Wanner C. Changes in adiponectin and risk of sudden death, stroke, myocardial infarction, and mortality in hemodialysis patients. Kidney Int. 2009;56:567–75.
    1. Krane V, Wanner C. Statins, inflammation and kidney disease. Nat Rev Nephrol. 2011;6:1573–79.
    1. Ketteler M, Schlieper G, Floege J. Calcification and cardiovascular health: new insights into an old phenomenon. Hypertension. 2006;47:1027–34.
    1. Schiffrin EL, Lipman ML, Mann JFE. Chronic kidney disease: effects on the cardiovascular system. Circulation. 2007;116:85–97.
    1. Herzog CA, Ma JZ, Collins AJ. Poor long-term survival after acute myocardial infarction among patients on long-term dialysis. N Engl J Med. 1998;339:799–805.
    1. Chertow GM, Normand SL, Silva LR, McNeil BJ. Survival after acute myocardial infarction in patients with end-stage renal disease: results from the cooperative cardiovascular project. Am J Kidney Dis. 2000;35:1044–51.
    1. Beattie JN, Soman SS, Sandberg KR, Yee J, Borzak S, Garg M. et al. Determinants of mortality after myocardial infarction in patients with advanced renal dysfunction. Am J Kidney Dis. 2001;37:1191–200.
    1. Masoudi FA, Plomondon ME, Magid DJ, Sales A, Rumsfeld JS. Renal insufficiency and mortality from acute coronary syndromes. Am Heart J. 2004;147:623–9.
    1. Wong JA, Goodman SG, Yan RT, Wald R, Bagnall AJ, Welsh RC. et al. Temporal management patterns and outcomes of non-ST elevation acute coronary syndromes in patients with kidney dysfunction. Eur Heart J. 2009;30:549–557.
    1. Fox CS, Muntner P, Chen AY, Alexander KP, Roe MT, Cannon CP. et al. Use of evidence-based therapies in short-term outcomes of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry. Circulation. 2010;121:357–365.
    1. Chertow GM, Normand SL, McNeil BJ. “Renalism”: inappropriately low rates of coronary angiography in elderly individuals with renal insufficiency. J Am Soc Nephrol. 2004;15(9):2462–8.
    1. Pyram R, Kansara A, Banerji MA. Loney-Hutchinson, LChronic kidney disease and diabetes. Maturitas. 2012;71(2):94–103.
    1. Alwakeel JS, Isnani AC, Alsuwaida A, Alharbi A, Shaffi SA, Almohaya S. et al. Factors affecting the progression of diabetic nephropathy and its complications: a singlecenter experience in Saudi Arabia. Ann Saudi Med. 2011;31(3):236–242.
    1. Hernandez GT, Sippel M, Mukherjee D. Interrelationship between Chronic Kidney Disease and Risk of Cardiovascular Diseases. Cardiovascular Hematological Agents in Medicinal Chemistry. 2013;11:38–43.
    1. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis 2007;49(2 Suppl 2):S12-154.
    1. Shurraw S, Hemmelgarn B, Lin M, Majumdar SR, Klarenbach S, Manns B. et al. Association between glycemic control and adverse outcomes in people with diabetes mellitus and chronic kidney disease: a population-based cohort study. Arch Intern Med. 2011;171(21):1920–7.
    1. Charytan DM, Setoguchi S, Solomon DH, Avorn J, Winkelmayer WC. Clinical presentation of myocardial infarction contributes to lower use of coronary angiography in patients with chronic kidney disease. Kidney Int. 2007;71:938–45.
    1. Apple FS, Murakami MM, Pearce LA, Herzog CA. Predictive value of cardiac troponin I and T for subsequent death in end-stage renal disease. Circulation. 2002;106:2941–5.
    1. Dasmahapatra P, Srinivasan SR, Mokha J, Fernandez C, Chen W, Xu J. et al. Subclinical atherosclerotic changes related to chronic kidney disease in asymptomatic black and white young adults: the Bogalusa Heart Study. Ann Epidemiol. 2011;21:311–17.
    1. Saltzman AJ, Stone GW, Claessen BE, Narula A, Leon-Reyes S, Weisz G. et al. Long-term impact of chronic kidney disease in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: the HORIZONS-AMI trial. JACC Cardiovasc Interv. 2011;4:1011–19.
    1. Fox CS1, Muntner P, Chen AY, Alexander KP, Roe MT, Cannon CP. et al. Use of evidence-based therapies in short-term outcomes on ST-setment elevation muocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network Registry. Circulation. 2010;121:357–65.
    1. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The fifth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice. Atherosclerosis. 2012;223:1–68.
    1. Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K. et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int. 2011;80:17–28.
    1. Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–93.
    1. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–91.

Source: PubMed

Подписаться