Chapter

Chronic kidney disease and cardiovascular disease

Daniel E. Weiner and Mark J. Sarnak

in Chronic Kidney Disease

Published on behalf of Oxford University Press

Published in print December 2009 | ISBN: 9780199549313
Published online February 2013 | e-ISBN: 9780191763465 | DOI: http://dx.doi.org/10.1093/med/9780199549313.003.0005

Series: Oxford Clinical Nephrology Series

Chronic kidney disease and cardiovascular disease

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Chronic kidney disease (CKD) is a potentially progressive condition marked by either reduced kidney function or the presence of kidney damage. Kidney function is quantified by the glomerular filtration rate (GFR), often estimated with equations that use serum creatinine and demographic characteristics. The early stages of CKD (stages 1 and 2) are defined by kidney damage (most often manifest with microalbuminuria) in the presence of intact GFR (>60mL/min/1.73m2), while later stages (stages 3 and 4) are associated with decreased GFR. In an individual with progressive kidney disease, kidney failure (CKD stage 5) ensues and renal replacement therapy (RRT) is required. However, most people with CKD never reach kidney failure; rather, they die prematurely of cardiovascular disease (CVD). Therefore, major therapeutic goals in individuals with CKD, aside from preventing the progression to kidney failure, include the recognition of increased cardiovascular risk and treatment of CVD risk factors and manifestations. In this section, we will discuss CKD as a risk state for CVD, describe factors that are associated with higher cardiovascular risk in individuals with CKD, review the aetiology, diagnosis. and treatment of CVD in patients with CKD, and discuss CVD as a risk factor for CKD. Key factors relevant to the primary and secondary management of CVD in patients with advanced CKD are presented in Table 5.1.

Chapter.  8641 words.  Illustrated.

Subjects: Nephrology ; Cardiovascular Medicine

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