Chronic kidney disease is a risk factor for cardiovascular disease

Chronic kidney disease (CKD) is worthy of attention of public health problems, the incidence gradually increased, and brought serious consequences and economic problems. Currently we noticed is the main treatment of patients with renal failure and renal transplant dialysis, but few scholars are concerned about the relationship between CKD and cardiovascular disease (CVD) is. CKD and CVD have been considered relevant, than the progress of acute renal failure is more likely to die of cardiovascular disease, CVD is the most common cause of death in CKD [1]. Recognizing that CKD is a risk factor for CVD that is very important. Only then will it be possible to carry out in-depth research, and then seek relevant preventive and therapeutic measures, so that these patients receive greater benefits.

CKD is defined by the relevant marker or biopsy proven renal damage> 3 months, or GFR <60ml / (min.1.73m2)> 3 months. Generally based on pathology and etiology of credit for the diabetic, non-diabetic kidney disease and post-transplant. Renal biopsy can damage or related markers such as proteinuria, abnormal urinary sediment, imaging to diagnose abnormalities. Proteinuria can only prove the presence of CKD can also become an important basis for the diagnosis of kidney disease type and severity and development of cardiovascular disease and kidney disease. Urinary albumin to creatinine ratio or total protein and creatinine ratio can be used to assess proteinuria. GFR <60ml / (min.1.73m2) as renal damage threshold level of GFR often precedes the start of renal failure, including increased incidence and degree of risk of cardiovascular disease. GFR <15ml / (min.1.73m2) requires dialysis.

GKD especially terminal renal disease (ESRD) patients , CVD risk increased significantly , typically achieved through the vascular tree . ESRD with atherosclerosis may causal relationship , on the one hand accelerated atherosclerosis progression of renal disease , on the other hand is a risk factor for ESRD deterioration of many traditional atherosclerosis [ 2 ] . In general, the basic types of CVD are two subtypes of vascular disease and heart disease, vascular disease is atherosclerosis and vascular remodeling , but the role of these two subtypes have CKD . Atherosclerotic plaque formation and occlusion mainly dominated , CKD in a high incidence of atherosclerosis and broader, diffuse atherosclerosis significantly increased cardiovascular mortality and accelerated deterioration of renal function . Atherosclerosis can lead to thickening of the arterial wall matrix and myocardial ischemia. In CKD patients, ischemic heart disease such as angina pectoris , myocardial infarction and sudden death , and cerebrovascular disease , peripheral vascular disease and heart failure are relatively common. Dialysis patients had initially thought might be secondary to ischemic heart disease is easy to overload , left ventricular hypertrophy and small artery disease , leading to reduction in oxygen supply . But later research found that the front area of erythropoietin , low hemoglobin levels , indicating ischemia may also be concerned with . CKD patients with vascular remodeling has a higher incidence of vascular remodeling can lead to pressure overload , and wall by wall thickening and lumen ratio increased or traffic overload to achieve, but mainly to increase the diameter and wall thickness Lord. Vascular remodeling often makes arterial compliance decreased, resulting in increased systolic blood pressure , pulse pressure , left ventricular hypertrophy and coronary perfusion decrease [ 3,4 ] . Decreased arterial compliance and increased pulse pressure were independent risk factors for cardiovascular disease in dialysis patients (CVD) [5 ] . Because sodium retention during dialysis can be treated by ultrafiltration , dialysis patients with heart failure diagnosis more difficult, but blood pressure, fatigue , loss of appetite and other signs of heart failure may be an important clue to the diagnosis ; hand, Shuinazhuliu more reflect ultrafiltration inappropriate, rather than heart failure or heart failure and ultrafiltration inappropriate . In fact, one reason ultrafiltration during dialysis is inappropriate hypertension, heart failure often prompts . Thus , dialysis patients with heart failure is an important indicator of poor prognosis , patients with cardiovascular disease, which often prompts are in progress .

In summary, chronic kidney disease (CKD) is closely related to cardiovascular disease (CVD). Especially for high-risk groups, either proteinuria or GFR decline were an independent risk factor for CVD outcomes. I suggest CVD or CVD risk factors in patients urinary albumin creatinine ratio routine examination or total protein creatinine ratio to assess GFR, while addressing CVD risk factors for CKD monitoring, prevention and treatment. Recent studies have indicated that renal dysfunction, even accompanied by severe CVD, such as myocardial infarction patients to receive ACEI, ARBs, statin therapy could reap the benefits, but requires further study, and therefore seek to CKD in CVD therapeutic potential has become imperative.