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Cardiovascular Disease: Coronary Artery Disease and Coronary Artery Calcification

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Cardiorenal Syndrome

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Abstract

Coronary artery disease is common in chronic kidney disease (CKD) and dialysis patients. There is strong evidence that kidney disease is an independent risk factor for atherosclerosis. In addition, traditional risk factors such as obesity, hypertension and diabetes, as well as nontraditional factors such as inflammation and oxidative stress, likely contribute to the excess risk of atherosclerosis in CKD. It remains to be determined whether low serum vitamin D levels and elevated fibroblast growth factor-23 (FGF-23) also play a role in atherosclerosis in CKD. There is some evidence to suggest that statins are useful in moderate CKD, but two large trials in dialysis patients showed no benefit of statin therapy. However, uremic dyslipidemia is characterized by low high-density-lipoprotein (HDL) cholesterol levels and increased triglyceride levels; statins are not effective in treating these lipid abnormalities. Beta blockers, aspirin and angiotensinconverting (ACE) inhibitors are likely effective therapies for treating coronary artery disease (CAD), but these remain very much underutilized. Similarly, despite evidence that coronary revascularization is useful in CKD and dialysis patients, these interventions are also underutilized in these populations.

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Authors and Affiliations

  1. Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    Srinivasan Beddhu

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  1. Srinivasan Beddhu
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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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Beddhu, S. (2010). Cardiovascular Disease: Coronary Artery Disease and Coronary Artery Calcification. In: Berbari, A.E., Mancia, G. (eds) Cardiorenal Syndrome. Springer, Milano. https://doi.org/10.1007/978-88-470-1463-3_12

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  • DOI: https://doi.org/10.1007/978-88-470-1463-3_12

  • 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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