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Titolo	Cardiovascular risk factors in chronic kidney disease
Autore	V. Menon, A. Gul, M.J. Sarnak
Referenza	Kidney International 2005 - 68 (4): 1413-1418
Contenuto	Cardiovascular disease is the primary cause of morbidity and premature mortality in chronic kidney disease. While it is well established that patients with kidney failure (chronic kidney disease stage 5) are at high risk of cardiovascular disease morbidity and mortality [1], patients with earlier stages of chronic kidney disease also experience a high rate of fatal and nonfatal cardiovascular events [2]. Recent guidelines and position statements have therefore defined chronic kidney disease as a cardiovascular risk equivalent, and patients in all stages of chronic kidney disease are considered in the \"highest risk group\" for development of cardiovascular disease [3]. We propose that patients with chronic kidney disease are at increased risk for cardiovascular disease for several reasons (Fig. 1): (1) chronic kidney disease is associated with increased prevalence of traditional and nontraditional cardiovascular disease risk factors; (2) chronic kidney disease is an independent risk factor for cardiovascular disease; (3) many cardiovascular disease risk factors are also risk factors for progression of chronic kidney disease; and (4) the presence of cardiovascular disease may be a risk factor for chronic kidney disease. The interrelationship between cardiovascular and chronic kidney disease, with each contributing to the pathogenesis of the other, leads to a cycle of cardiovascular and kidney disease progression. In the current review we focus on chronic kidney disease stages 1 to 4 and (1) present evidence suggesting that markers of chronic kidney disease, including reduced glomerular filtration rate (GFR) and microalbuminuria, are independent risk factors for cardiovascular disease, (2) describe the spectrum of cardiovascular disease in chronic kidney disease, and (3) discuss the role of traditional and nontraditional risk factors in the development of the different forms of cardiovascular disease. We do not describe management strategies as this is discussed in an accompanying review.
Data	14.10.2005

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