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Cardiovascular Issues in Chronic Kidney Disease Reviewed

Mechanisms that lead to morbidity and mortality diverse and complicated

WEDNESDAY, June 3 (HealthDay News) -- Chronic kidney disease (CKD) raises the risk of cardiovascular problems and can lead to complications following revascularization procedures, according to a review published in the June 9 issue of the Journal of the American College of Cardiology, and greater understanding of the mechanisms involved could lead to improved treatment.

Fadi G. Hage, M.D., of the University of Alabama in Birmingham, and colleagues discuss the relationship between CKD and coronary heart disease (CHD), pointing out that most patients with CKD die of cardiovascular-related causes before developing end-stage renal disease.

The authors write that most traditional risk factors for CHD, including diabetes and hypertension, are more prevalent in individuals with CKD. In addition, interest is growing in other cardiovascular risk factors in patients with CKD, including inflammation, vascular calcification, anemia, and left ventricular hypertrophy. Patients with CKD have a higher risk of complications from percutaneous coronary revascularization and coronary artery bypass grafting.

"CKD is a serious health problem worldwide that leads to devastating CHD morbidity and mortality. The mechanisms that lead to these events are diverse and far more complicated than in patients with normal renal function. CHD is uniquely different in CKD from that in the general population, with earlier onset in life, more rapid progression, a closer association with calcification, increased vascular stiffness, resistance to statin medications, higher complications with percutaneous and surgical revascularization, and higher rates of sudden death," Hage and colleagues conclude.

A co-author reported financial ties to Astellas, CV Therapeutics, and Molecular Imaging.

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