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Links between Chronic Kidney Disease and Cardiovascular Disease: A Bidirectional Relationship

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Cardiorenal Syndrome

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Abstract

A strong relationship between chronic kidney disease (CKD) and accelerated cardiovascular disease, defined as the cardiorenal syndrome, is well documented, whether the initial event is in the kidney or in the heart. In the kidney context, mechanisms that link CKD and cardiovascular disease (CVD) involve both conventional and CKD (uremia)-related CVD risk factors. Several pathophysiologic processes responsible for the accelerated CVD spectrum in the CKD population include accelerated calcific occlusive atheromatous disease, diffuse nonocclusive medial-wall calcification, endothelial dysfunction, and uremic cardiomyopathy. In the heart context, disturbed CV dynamics and activation of neurohormonal and inflammatory factors are involved in the initiation of renal functional impairment and progressive kidney disease.

The aim of this chapter is to present an overview of various aspects of cardiorenal association and to pinpoint features that are specific to each clinical entity, whether the initial insult is renal or cardiac. A detailed discussion of the various aspects of cardiorenal association are well covered in the following chapters.

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References

  1. Weiner DE, Tighiourt H, Amin M et al (2004) Chronic kidney disease as a risk factor for cardiovascular disease and all cause mortality, a pooled analysis of community based studies. J Am Soc Nephrol 15:1307–1315

    Article  PubMed  Google Scholar 

  2. Healthy People 2010 (2006) 2005 annual data report. Am J Kidney Dis 47:S33–S46

    Article  Google Scholar 

  3. Collins AJ, Li S, Gilbertson DT et al (2003) Chronic kidney disease and cardiovascular disease in the medicare population. Kidney Int 87(Supp l):S24–S31

    Article  Google Scholar 

  4. Brown JR, Cochran RP, Dacey LJ et al (2006) Perioperative increases in serum creatinine are predictive of increased 90 days, mortality after coronary artery bypass graft surgery. 114:1409–1413

    Google Scholar 

  5. Gruberg L, Weissman NJ, Waksman R et al (2002) Comparison of outcomes after percutaneous coronary revascularization with stents in patients with and without mild chronic renal insufficiency. Am J Cardiol 89:54–57

    Article  PubMed  Google Scholar 

  6. Ronco C, House AA, Haapio M (2008) Cardiorenal syndrome: refining the definition of a complex symbiosis gone wrong. Intensive Care Med 134:1017–1018

    Google Scholar 

  7. Schrier RW (2007) Cardiorenal versus renocardiac syndrome: is there a difference? Nat Clin Pract Nephrol 3:637

    Article  PubMed  Google Scholar 

  8. United States Renal Data System (1998) USRDS 1998 annual data report. Available at http://www.usrds.org/adr_1998.htm. Accessed 20 Mar 2010

    Google Scholar 

  9. Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidn Dis 32:S112–S119

    Article  CAS  Google Scholar 

  10. Coresh J, Selvin E, Stevens LA et al (2007) Prevalence of chronic kidney disease in the United States. JAMA 298:2038–2047

    Article  CAS  PubMed  Google Scholar 

  11. Sarnak MJ, Cochair MD, Levey AS et al (2003): Kidney disease as a risk factor for development of cardiovascular disease. A statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology and Epidemiology and Prevention. Circulation 108:2154–2169

    Article  PubMed  Google Scholar 

  12. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease. Evaluation, classification and stratification. Am J Kidn Dis 39(2 Suppl 1) S1–S266

    Google Scholar 

  13. Garg Ax, Kiberd BA, Clark WF et al (2002) Albuminuria and renal insufficiency prevalence guides population screening: results from the NHAMES III. Kidney Int 61:2165–2175

    Article  PubMed  Google Scholar 

  14. Rucker D, Tonelli M (2009) Cardiovascular risk and management in chronic kidney disease. Nat Rev Nephrol 5:287–296

    Article  PubMed  Google Scholar 

  15. Nogueira J, Weir M (2007) The unique character of cardiovascular disease in chronic kidney disease and its implications for treatment with lipid-lowering drugs. Clin J Am Soc Nephrol 2:766–785

    Article  CAS  PubMed  Google Scholar 

  16. Culleton GF, Larson MG, Wilson PWF et al (1999) Cardiovascular disease and mortality in a community based cohort with mild renal insufficiency. Kidney Int 56:2214–2219

    Article  CAS  PubMed  Google Scholar 

  17. Nicholls SJ, Tuzcu EM, Hsu A et al (2007) Comparison of coronary atherosclerotic volume in patients with glomerular filtration rates ≤60 versus >60ml/min/1.73m2: a meta-analysis of intravascular ultrasound studies. Am J Cardiol 99:813–816

    Article  PubMed  Google Scholar 

  18. Muntner P, Hamm L, Kusek JW et al (2004) The prevalence of nontraditional risk factors for coronary heart disease in patients with chronic kidney disease. Ann Intern Med 140:9–17

    PubMed  Google Scholar 

  19. Rigatto C, Levin A, House AA et al (2009) Atheroma progression in chronic kidney disease. Clin J Am Soc Nephrol 4:291–298

    Article  CAS  PubMed  Google Scholar 

  20. London GM, Marchais SJ, Guerin AP, Metivier F (2005) Arteriosclerosis, vascular calcifications and cardiovascular disease in uremia. Curr Opin Nephrol Hypertens 14:525–531

    Article  CAS  PubMed  Google Scholar 

  21. Jono S, Mckee MD, Murry CE et al (2000) Phosphate regulation of vascular smooth muscle cell calcification Circ Res 87:e10–e17

    CAS  PubMed  Google Scholar 

  22. Chen NX, O’Neill KD, Duan D, Moe SH (2002) Phosphorous and uremic serum up-regulate osteopontin expression in vascular smooth muscle cells. Kidney Int 63:1724–1731

    Article  Google Scholar 

  23. Kestenbaum B, Samson JN, Rudser KD et al (2005) Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol 16:520–528

    Article  CAS  PubMed  Google Scholar 

  24. Mourad JJ, Pannier B, Blacher J et al (2001) Creatinine clearance, pulse wave velocity, carotid compliance and essential hypertension. Kidney Int 59:1834–1841

    Article  CAS  PubMed  Google Scholar 

  25. Dhingra R, Sullivan LM, Fox CS et al (2007) Relations of serum phosphorous and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med 167:879–885

    Article  CAS  PubMed  Google Scholar 

  26. Culleton BF, Larson MJ, Evans JC et al (1999) Prevalence and correlates of elevated serum creatinine levels: The Framingham Heart Study. Arch Intern Med 159:1785–1790

    Article  CAS  PubMed  Google Scholar 

  27. Safar ME, Nawar T, Plante GE (2007) Large arteries and the kidney. J Am Soc Hypertens 1:169–177

    Article  PubMed  Google Scholar 

  28. Eizawa T, Murakami Y, Matsui T et al (2003) Circulating endothelial progenitor cells are reduced in hemodialysis patients. Curr Med Res Opin 19:627–633

    Article  PubMed  Google Scholar 

  29. Rostand SG, Kirk KA, Rutsky EA (1984) Dialysis associated ischemic heart disease: insights from coronary angiography. Kidney Int 25:653–659

    Article  CAS  PubMed  Google Scholar 

  30. Amann K, Ritz E (2001) The heart in renal failure: Morphological changes of the myocardium — New insights. J Clin Basic Cardiol 4:109–113

    Google Scholar 

  31. . Beddhu S, Allen-Brady K, Cheung AK (2002) Impact of renal failure on the risk of myocardial infarction and death. Kidney Int 62:1776–1783

    Article  PubMed  Google Scholar 

  32. GO S, Chertow GM, Fan D et al (2004) Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N Engl J Med 351:1296–1305

    Article  CAS  PubMed  Google Scholar 

  33. Zoccali C (2008) Cardiovascular risk in patients with chronic kidney disease: not high enough to enter the major league? Curr Hyper Rep 10:1–2

    Article  Google Scholar 

  34. Dimeny EM (2002) Cardiovascular disease after renal transplantation. Kidney Int 61:S78–S84

    Article  Google Scholar 

  35. Laskar SR, Dries DL (2003) The prognostic significance of renal dysfunction in patients with chronic heart failure. Curr Cardiol Rep 5:205–210

    Article  PubMed  Google Scholar 

  36. Dzau VJ (1989) Renal and circulatory mechanisms in congestive heart failure. Kidney Int 31:1402–1415

    Article  Google Scholar 

  37. Vasan RS, Larson MG, Benjamin EJ et al (1999) Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. J Am Coll Cardiol 33:1948–1955

    Article  CAS  PubMed  Google Scholar 

  38. Bhatia RS, Tu JV, Lee DS et al (2006) Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 355:260–269

    Article  CAS  PubMed  Google Scholar 

  39. Silverberg D, Wexler D, Blum M et al (2004) The association between congestive heart failure and chronic renal disease. Curr Opin Nephrol Hypertens 13:163–170

    Article  CAS  PubMed  Google Scholar 

  40. Spanaus KS, Kronenberg F, Ritz E et al (2007) B-type natriuretic peptide concentrations predict the progression of nondiabetic chronic kidney disease: the mild to moderate kidney disease study. Clin Chem 53:1264–1272

    Article  CAS  PubMed  Google Scholar 

  41. Van Dokkum RPE, Eijkelkamp WBA, Kluppel ACA et al (2004) Myocardial infarction enhances progressive renal damage in an experimental model for cardio-renal interaction. J Am Soc Nephrol 15:3103–3110

    Article  PubMed  Google Scholar 

  42. Tracy RE, Strong JP, Newman III WP et al (1996) Renovasculopathies of nephrosclerosis in relation to atherosclerosis at age 25 to 54 years. Kidney Int 49:564–570

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Adel E. Berbari

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  1. Adel E. Berbari
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Editors and Affiliations

  1. Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Adel E. Berbari

  2. Clinica Medica Department of Clinical Medicine and Prevention, University of Milano-Bicocca San Gerardo Hospital, Monza, Milan, Italy

    Giuseppe Mancia

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Berbari, A.E. (2010). Links between Chronic Kidney Disease and Cardiovascular Disease: A Bidirectional Relationship. In: Berbari, A.E., Mancia, G. (eds) Cardiorenal Syndrome. Springer, Milano. https://doi.org/10.1007/978-88-470-1463-3_1

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  • DOI: https://doi.org/10.1007/978-88-470-1463-3_1

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1462-6

  • Online ISBN: 978-88-470-1463-3

  • eBook Packages: MedicineMedicine (R0)

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