Cardiorenal Syndrome - Mechanisms, Risk and Treatment

di Berbari - Mancia • 2010 • dettagli prodotto

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DESCRIZIONE

Accelerated cardiovascular disease is a frequent complication of chronic kidney disease. Individuals with evidence of renal functional impairment are more likely to die of cardiovascular events than to progress to end stage renal disease. This relationship, which has been termed the cardiorenal syndrome, exists whether impairment of renal function is a consequence of primary renal parenchymal or primary heart disease. The mechanisms underlying the cardiorenal syndrome result from a complex interaction of traditional and uremia related cardiovascular risk factors. Prevention and management of cardiovascular disease include aggressive control of traditional risk factors as well novel approach to prevent or reverse uremia related processes. Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease.Table of contents Introduction: Links between chronic kidney (CKD) and cardiovascular disease (CVD): a bidirectional relationship.- Cross talk between the cardiovascular system and the kidney: Structural and functional similarities between vascular smooth muscle cells (VSMC) and glomerular mesangial cells (GMC). Regulation of VSMC and GMC by common mediators in health and disease.- Chronic kidney as a risk for the development of cardiovascular disease: Epidemiologic links between impaired renal function and cardiovascular events. Definition and classification of stages of severity of CKD. Classification of cardiovascular risk factors in CKD. Spectrum of CVD in CKD. Mechanisms of cardiovascular complications in CKD.- Cardiovascular disease as a promoter of CKD: Mechanisms. Prognostic significance.- Therapeutic modalities.