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Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association
Chronic kidney disease (CKD) is classified into five stages with kidney failure being the most severe stage (stage G5). CKD conveys a high risk for coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Cardiovascular complications are the most common causes of death in patie...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478756/ https://www.ncbi.nlm.nih.gov/pubmed/37249051 http://dx.doi.org/10.1093/cvr/cvad083 |
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author | Zoccali, Carmine Mallamaci, Francesca Adamczak, Marcin de Oliveira, Rodrigo Bueno Massy, Ziad A Sarafidis, Pantelis Agarwal, Rajiv Mark, Patrick B Kotanko, Peter Ferro, Charles J Wanner, Christoph Burnier, Michel Vanholder, Raymond Wiecek, Andrzej |
author_facet | Zoccali, Carmine Mallamaci, Francesca Adamczak, Marcin de Oliveira, Rodrigo Bueno Massy, Ziad A Sarafidis, Pantelis Agarwal, Rajiv Mark, Patrick B Kotanko, Peter Ferro, Charles J Wanner, Christoph Burnier, Michel Vanholder, Raymond Wiecek, Andrzej |
author_sort | Zoccali, Carmine |
collection | PubMed |
description | Chronic kidney disease (CKD) is classified into five stages with kidney failure being the most severe stage (stage G5). CKD conveys a high risk for coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Cardiovascular complications are the most common causes of death in patients with kidney failure (stage G5) who are maintained on regular dialysis treatment. Because of the high death rate attributable to cardiovascular (CV) disease, most patients with progressive CKD die before reaching kidney failure. Classical risk factors implicated in CV disease are involved in the early stages of CKD. In intermediate and late stages, non-traditional risk factors, including iso-osmotic and non-osmotic sodium retention, volume expansion, anaemia, inflammation, malnutrition, sympathetic overactivity, mineral bone disorders, accumulation of a class of endogenous compounds called ‘uremic toxins’, and a variety of hormonal disorders are the main factors that accelerate the progression of CV disease in these patients. Arterial disease in CKD patients is characterized by an almost unique propensity to calcification and vascular stiffness. Left ventricular hypertrophy, a major risk factor for heart failure, occurs early in CKD and reaches a prevalence of 70–80% in patients with kidney failure. Recent clinical trials have shown the potential benefits of hypoxia-inducible factor prolyl hydroxylase inhibitors, especially as an oral agent in CKD patients. Likewise, the value of proactively administered intravenous iron for safely treating anaemia in dialysis patients has been shown. Sodium/glucose cotransporter-2 inhibitors are now fully emerged as a class of drugs that substantially reduces the risk for CV complications in patients who are already being treated with adequate doses of inhibitors of the renin-angiotensin system. Concerted efforts are being made by major scientific societies to advance basic and clinical research on CV disease in patients with CKD, a research area that remains insufficiently explored. |
format | Online Article Text |
id | pubmed-10478756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-104787562023-09-06 Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association Zoccali, Carmine Mallamaci, Francesca Adamczak, Marcin de Oliveira, Rodrigo Bueno Massy, Ziad A Sarafidis, Pantelis Agarwal, Rajiv Mark, Patrick B Kotanko, Peter Ferro, Charles J Wanner, Christoph Burnier, Michel Vanholder, Raymond Wiecek, Andrzej Cardiovasc Res Invited Review Chronic kidney disease (CKD) is classified into five stages with kidney failure being the most severe stage (stage G5). CKD conveys a high risk for coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Cardiovascular complications are the most common causes of death in patients with kidney failure (stage G5) who are maintained on regular dialysis treatment. Because of the high death rate attributable to cardiovascular (CV) disease, most patients with progressive CKD die before reaching kidney failure. Classical risk factors implicated in CV disease are involved in the early stages of CKD. In intermediate and late stages, non-traditional risk factors, including iso-osmotic and non-osmotic sodium retention, volume expansion, anaemia, inflammation, malnutrition, sympathetic overactivity, mineral bone disorders, accumulation of a class of endogenous compounds called ‘uremic toxins’, and a variety of hormonal disorders are the main factors that accelerate the progression of CV disease in these patients. Arterial disease in CKD patients is characterized by an almost unique propensity to calcification and vascular stiffness. Left ventricular hypertrophy, a major risk factor for heart failure, occurs early in CKD and reaches a prevalence of 70–80% in patients with kidney failure. Recent clinical trials have shown the potential benefits of hypoxia-inducible factor prolyl hydroxylase inhibitors, especially as an oral agent in CKD patients. Likewise, the value of proactively administered intravenous iron for safely treating anaemia in dialysis patients has been shown. Sodium/glucose cotransporter-2 inhibitors are now fully emerged as a class of drugs that substantially reduces the risk for CV complications in patients who are already being treated with adequate doses of inhibitors of the renin-angiotensin system. Concerted efforts are being made by major scientific societies to advance basic and clinical research on CV disease in patients with CKD, a research area that remains insufficiently explored. Oxford University Press 2023-05-30 /pmc/articles/PMC10478756/ /pubmed/37249051 http://dx.doi.org/10.1093/cvr/cvad083 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Invited Review Zoccali, Carmine Mallamaci, Francesca Adamczak, Marcin de Oliveira, Rodrigo Bueno Massy, Ziad A Sarafidis, Pantelis Agarwal, Rajiv Mark, Patrick B Kotanko, Peter Ferro, Charles J Wanner, Christoph Burnier, Michel Vanholder, Raymond Wiecek, Andrzej Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title | Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title_full | Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title_fullStr | Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title_full_unstemmed | Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title_short | Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association |
title_sort | cardiovascular complications in chronic kidney disease: a review from the european renal and cardiovascular medicine working group of the european renal association |
topic | Invited Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478756/ https://www.ncbi.nlm.nih.gov/pubmed/37249051 http://dx.doi.org/10.1093/cvr/cvad083 |
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