Many with CKD die from Cardiovascular Disease instead of Kidney Disease

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Patients with Chronic Kidney Disease are more likely to develop cardiovascular disease than others. Cardiovascular disease accounts for more than half of all deaths among people with kidney failure. Although emphasis is placed on delaying the progression of chronic kidney disease, it must be appreciated that for many patients it is vital to address their cardiovascular risk factors to prevent premature cardiovascular death.

Once patients reach end stage kidney disease (CKD stage 5), and enter dialysis programs they have an alarmingly high rate of cardiovascular death with those in the youngest age range of <25 years having equivalent cardiovascular mortality rates to 75- to 85-year-olds in the general population. Hence there is now increasing interest in the cardiovascular status of patients with earlier stages of CKD where efforts can be made to prevent cardiovascular disease from occurring. In patients with kidney disease the basic biology underlying cardiovascular disease may be similar to that in patients without kidney disease, but it would seem many more risk factors are involved as a consequence of renal dysfunction. The risk factors for CKD patients regarding cardiovascular disease include:

High Blood Pressure

Kidneys are important in regulating blood pressure by controlling renin (a protein that is released by special kidney cells) production. When kidneys fail they may release too much renin, which can lead to high blood pressure. High blood pressure means the blood produces excessive force on the blood vessels. Increased force damages blood vessels in the organs, such as the heart.

High Homocysteine Level

Healthy kidneys regulate the amount of homocysteine (an amino acid) in the blood by removing any excess. High levels of homocysteine may damage the lining of the blood vessels, making a person prone to blood clots which increases the risk of stroke and heart attack.

Anemia

Kidney Failure causes a shortage of erythropoietin (EPO) which leads to anemia (an inability to produce an adequate amount of red blood cells). Therefore, without enough of the hormone, EPO, a person will not have the necessary blood and oxygen supply to avoid a heart attack.

Diabetes

Diabetes means high blood sugar, which may cause damage to the blood vessels in the kidneys. Thereby, affecting the kidneys (diabetic neuropathy) and the heart, causing cardiovascular disease.

Chronic Kidney Disease patients must be diligent in taking appropriate measures to reduce cardiovascular risk. This can be accomplished by working with your healthcare team to tailor a practical "healthy living" treatment plan.

Reference: Wright, Julian, and Alastair Hutchison. "Abstract." National Center for Biotechnology Information. U.S. National Library of Medicine

Recommended Readings:

How Long Can People with Renal Failure Live on Dialysis
More Thorough Dialysis May Increase Life Expectancy