Review
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World J Nephrol. Nov 6, 2014; 3(4): 156-168
Published online Nov 6, 2014. doi: 10.5527/wjn.v3.i4.156
Cardiovascular co-morbidity in chronic kidney disease: Current knowledge and future research needs
Hudaifa Alani, Asad Tamimi, Nihad Tamimi
Hudaifa Alani, Broomfield Hospital, Mid Essex NHS Trust, CM1 7ET Chelmsford, United Kingdom
Asad Tamimi, University College London Hospital, NW1 2BU London, United Kingdom
Nihad Tamimi, Pfizer Worldwide Research and Development, Cambridge, MA 02139, United States
Author contributions: All authors contributed to this paper
Correspondence to: Dr. Nihad Tamimi, MBBS, MSc, FRCP, Pfizer Worldwide Research and Development, Pfizer Inc, 610 Main Street, Cambridge, MA 02139, United States. nihad.tamimi@pfizer.com
Telephone: +44-7811-368079
Received: June 26, 2014
Revised: September 30, 2014
Accepted: October 14, 2014
Published online: November 6, 2014
Abstract

Chronic kidney disease (CKD) is recognised as a health concern globally and leads to high rates of morbidity, mortality and healthcare expenditure. CKD is itself an independent risk factor for unfavorable health outcomes that include cardiovascular disease (CVD). Coronary artery disease is the primary type of CVD in CKD patients and a significant cause of death among renal transplant patients. Traditional and non-traditional risk factors for CVD exist in patients with CKD. Traditional factors include smoking, hypertension, dyslipidemia and diabetes which are highly prevalent in CKD patients. Non-traditional risk factors of CKD are mainly uraemia-specific and increase in prevalence as kidney function declines. Some examples of uraemia-specific risk factors that have been well documented include low levels of haemoglobin, albuminuria, and abnormal bone and mineral metabolism. Therapeutic interventions targeted at more traditional risk factors which contribute to CVD, have not had the desired effect on lowering CVD events and mortality in those suffering with CKD. Future research is warranted to delineate clear evidence to the benefit of modifying non-traditional risk factors.

Keywords: Cardiovascular disease, Chronic kidney disease, Risk factors, Inflammation

Core tip: Chronic kidney disease (CKD) has been recognised as a health concern globally and leads to high morbidity, mortality and healthcare expenditure. CKD is an independent risk factor for several different unfavourable outcomes including cardiovascular disease (CVD). Traditional and non-traditional risk factors for CVD exist in patients with CKD. Non-traditional risk factors of CKD are mainly uraemia-specific and include release of large levels of inflammatory and prothrombotic factors, low levels of haemoglobin, albuminuria, and abnormal bone and mineral metabolism. Future research is warranted to delineate clear evidence to the benefit of modifying non-traditional risk factors