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. 2008 Aug;4(3):198-202.
doi: 10.2174/157340308785160543.

Progression of renal dysfunction in patients with cardiovascular disease

Yasunobu Hirata  1 , Arihiro Kiyosue, Masao Takahashi, Hiroshi Satonaka, Daisuke Nagata, Masataka Sata, Etsu Suzuki, Ryozo Nagai
Affiliations

Progression of renal dysfunction in patients with cardiovascular disease

Yasunobu Hirata et al. Curr Cardiol Rev. 2008 Aug.

Abstract

It has been established that patients with chronic kidney disease (CKD) suffer from frequent cardiovascular events. On the other hand, recent studies suggest that renal damage tends to worsen in patients with cardiovascular diseases (CVD). Although the mechanisms for the cardiorenal association are unclear, the presence of arteriosclerotic risk factors common to both CVD and CKD is important. In arteriosclerosis, vascular derangement progresses not only in the heart but also in the kidney. In addition, heart failure, cardiac catheterization and hesitation of medical treatments due to renal dysfunction may explain the progression of renal damage. Therefore, the goal of treatments is a total control of arteriosclerotic risk factors. Medication should be selected among agents with protective effects on both heart and kidney. It is important to always consider the presence of CKD for the treatment of the cardiovascular disease and strictly control the risk factors.

Keywords: ARB; CKD; aldosterone; angiotensin II; hypertension..

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Figures

Fig. (1)
Fig. (1)
Proposed pathophysiological mechanisms for cardiorenal syndrome. DM: diabetes mellitus, RAAS: renin angiotensin alsosterone system, SNA: sympathetic nervous activity, ADMA: asymmetric dimethylarginine.
Fig. (2)
Fig. (2)
Time course changes in cardiac and renal functions in patients with dilated cardiomyopathy after implantation of left ventricular assist device (LVAD). DOA: dopamine, DOB: dobutamine, CI: cardiac index, Cr: creatinine, BNP: B-type natriuretic peptide.
Fig. (3). Compensatory mechanisms for renal dysfunction and volume retention in heart failure.
Fig. (3). Compensatory mechanisms for renal dysfunction and volume retention in heart failure.
HT: hypertension, DM: diabetes mellitus, HL: hyperlipidemia, LVH: left ventricular hypertrophy, CHD: coronary heart disease, CO: cardiac output, prs: pressure, BP: blood pressure, SNA: sympathetic nervous activity, RAS: renin angiotensin system, AVP: arginine vasopressin, RBF: renal blood flow, GFR: glomerular filtration rate, FF: filtration fraction, ↓: decrease or constriction, ↑: increase or dilatation
Fig. (4)
Fig. (4)
Photograph of the biopsed skin from a patient with cholesterol emboli. Arrow heads indicate cholesterol crystals. Taken from ref. [18]; Matsumura T, Hirata Y, et al. Am J Med Sci 2006; 331: 280-3.
See this image and copyright information in PMC

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