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Management of Cardiovascular Disease in Chronic Kidney Disease

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Management of Chronic Kidney Disease

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Abstract

Ischemic heart disease as a result of coronary atherosclerosis occurs when there is a mismatch between myocardial oxygen supply and demand. Reductions in myocardial perfusion result in decreased oxygen delivery, reduced adenosine triphosphate and lactic acidosis, and release of adenosine, all of which activate visceral afferent signals to the brain resulting in chest discomfort or angina. There are many determinants of atherosclerosis including elevated low-density lipoprotein cholesterol, diabetes mellitus, hypertension, smoking, family history, and obesity. Targeting these risk factors with medical therapy and lifestyle changes results in substantial improvements in symptoms and reductions in nonfatal and fatal cardiovascular events. Chronic ischemia and kidney dysfunction can alter myocardial structure and function, which may lead to the development of heart failure. Not surprisingly, kidney patients with pump failure have poorer outcomes and challenging disease management problems. This chapter will discuss the treatment of coronary atherosclerosis, heart failure, valvular disease, and arrhythmias in the setting of chronic kidney disease.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Providence Hospitals and Medical Centers, 16001 West Nine Mile Rd, Southfield, MI, 48075, USA

    Mohammad Nasser MD

  2. Department of Cardiovascular Medicine, Baylor Heart and Vascular Institute, Baylor University Medical Center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, TX, USA

    Peter A. McCullough MD, MPH

  3. The Heart Hospital, Plano, USA

    Peter A. McCullough MD, MPH

Authors
  1. Mohammad Nasser MD
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  2. Peter A. McCullough MD, MPH
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Corresponding author

Correspondence to Mohammad Nasser MD .

Editor information

Editors and Affiliations

  1. Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Mustafa Arici

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© 2014 Springer-Verlag Berlin Heidelberg

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Nasser, M., McCullough, P.A. (2014). Management of Cardiovascular Disease in Chronic Kidney Disease. In: Arici, M. (eds) Management of Chronic Kidney Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54637-2_13

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  • DOI: https://doi.org/10.1007/978-3-642-54637-2_13

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54636-5

  • Online ISBN: 978-3-642-54637-2

  • eBook Packages: MedicineMedicine (R0)

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