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Epicardial Coronary Heart Disease in CKD: Diagnosis and Management

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Cardio-Renal Clinical Challenges

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Abstract

Chronic kidney disease (CKD) is an increasingly common problem, affecting approximately 10 % of the world’s population [1]. Patients with CKD are at increased risk of cardiovascular disease, and in fact, cardiac causes account for more than 50 % of deaths in CKD patients [2]. And yet, coronary artery disease remains underdiagnosed and undertreated in this population. Recognition of underlying coronary artery disease can be complicated in CKD patients because many are asymptomatic [3]. Several small studies have demonstrated obstructive coronary lesions (defined as stenosis greater than 50 % of the lumen diameter) in up to 50 % of asymptomatic patients with CKD (stages 4 and 5) [4, 5]. The paucity of symptoms may be due to a variety of factors, including neuropathy [6] and decreased exercise tolerance. In addition, subtle symptoms such as dyspnea on exertion or fatigue may be attributed to other causes, such as anemia.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, University of Missouri Health System, 1 Hospital Drive, Columbia, 65212, MO, USA

    Rachel L. Littrell MD, MPH & Martin A. Alpert MD

  2. Department of Cardiovascular Medicine, University of Missouri Hospital and Clinics, CE306, 5 Hospital Drive, Columbia, 65212, MO, USA

    Kul Aggarwal MD, MRCP (UK), FACC

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  1. Rachel L. Littrell MD, MPH
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  2. Martin A. Alpert MD
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  3. Kul Aggarwal MD, MRCP (UK), FACC
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Correspondence to Kul Aggarwal MD, MRCP (UK), FACC .

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Editors and Affiliations

  1. Renal and Transplantation Department, Guy's Hospital, London, United Kingdom

    David Goldsmith

  2. Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  3. Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden

    Jonas Spaak

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Littrell, R.L., Alpert, M.A., Aggarwal, K. (2015). Epicardial Coronary Heart Disease in CKD: Diagnosis and Management. In: Goldsmith, D., Covic, A., Spaak, J. (eds) Cardio-Renal Clinical Challenges. Springer, Cham. https://doi.org/10.1007/978-3-319-09162-4_1

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