Cardiovascular risk and management in chronic kidney disease

Nat Rev Nephrol. 2009 May;5(5):287-96. doi: 10.1038/nrneph.2009.42.


Chronic kidney disease (CKD) is associated with accelerated progression of cardiovascular disease, perhaps because patients with CKD have a high burden of traditional cardiovascular risk factors in addition to a range of nontraditional risk factors such as inflammation and abnormal metabolism of calcium and phosphate. Although the cardiovascular burden of CKD is well documented, potentially beneficial therapies are sometimes underused in patients with stage 3-4 CKD and are rarely studied in patients on dialysis. In this Review, we describe the epidemiology of cardiovascular disease in patients with stage 3-5 CKD (excluding kidney transplant recipients) and outline cardiovascular risk factors that are relevant in this population; we then discuss the implications of this knowledge for the optimal management of cardiovascular risk in this setting. Finally, we highlight opportunities for further research.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / therapy*
  • Humans
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / therapy*
  • Risk Factors