| Theme |
Heart and it's Diseases in Dialysis Patients -- For their better longevity |
| Title |
Chronic kidney disease and heart failure |
| Author |
Naoki Nakagawa |
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical College |
| Author |
Naoyuki Hasebe |
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical College |
| [ Summary ] |
Chronic kidney disease (CKD) is now recognized as a risk factor for both end-stage renal disease and independently for cardiovascular disease (CVD). CVD remains the leading cause of morbidity and mortality in patients receiving dialysis. It is important to note that even in patients with mild kidney disease, the risk of cardiovascular events and death is elevated relative to patients without evidence of kidney disease, because of the prevalence of many traditional CVD risk factors, such as hypertension, diabetes, dyslipidemia, and left ventricular hypertrophy. In addition, reduced renal function is associated with increased nontraditional risk factors, such as anemia, inflammation, oxidative stress and abnormalities of calcium and phosphorus metabolism. Recently, a novel clinical entity termed cardio-renal anemia (CRA) syndrome, has been recognized in which anemia plays a key role in worsening both CKD and cardiac performance in a vicious circle. Appropriate and vigorous treatment of anemia has now been accepted to eliminate or moderate this vicious circle. Patients with CKD should be considered a high-risk population for CVD and be recommended for more intensive preventive management of CVD, including active detection and precise treatment of CVD risk factors. |