Determinants and Prevention of Coronary Disease in Patients With Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is associated with premature cardiovascular morbidity and mortality. Traditional Framingham risk factors contribute partially to the malignant form of cardiovascular disease in CKD. Uremic-specific risk factors including chronic inflammation, retention of uremic toxins, and abnormal bone mineral metabolism have independently been linked to the pathogenesis of premature vascular aging, atherosclerosis, and cardiovascular disease. In this review we explore the mechanisms by which premature aging occurs in CKD through its pathologic effects on cardiovascular health, and the determinants of cardiac disease in patients with CKD. We outline strategies for prevention and therapeutic interventions in this vulnerable population.