Looking Beyond the Glomerulus for Cardiovascular Health.

The American journal of cardiology(2023)

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摘要
The cardiovascular system and the renal physiology are intricately regulated and balanced by the renin-angiotensin system. While in the pathologic state, the dysfunction of 1 system accentuates the pathological progression of the other system. 1 Jankowski J Floege J Fliser D Böhm M Marx N. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation. 2021; 143: 1157-1172 Crossref PubMed Scopus (310) Google Scholar Chronic kidney disease is an established risk factor for cardiovascular disease, with nearly 50% prevalence and 50% mortality among patients with stage 4 and 5 chronic kidney disease. 2 Stevens PE O'Donoghue DJ de Lusignan S Van Vlymen J Klebe B Middleton R Hague N New J Farmer CK. Chronic kidney disease management in the United Kingdom: NEOERICA project results. Kidney Int. 2007; 72: 92-99 Abstract Full Text Full Text PDF PubMed Scopus (310) Google Scholar Traditional measures of renal dysfunction have been glomerular filtration rate, serum creatinine, and albuminuria. 3 National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39: S1-S266 PubMed Google Scholar These are markers of renal glomerular function, and multiple studies have demonstrated that the deterioration levels of these markers are associated with the progression of cardiovascular disease. 4 Matsushita K van der Velde M Astor BC Woodward M Levey AS de Jong PE Coresh J Gansevoort RT. Chronic Kidney Disease Prognosis ConsortiumAssociation of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010; 375: 2073-2081 Abstract Full Text Full Text PDF PubMed Scopus (2912) Google Scholar ,5 Levey AS de Jong PE Coresh J El Nahas M Astor BC Matsushita K Gansevoort RT Kasiske BL Eckardt KU The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011; 80: 17-28 Abstract Full Text Full Text PDF PubMed Scopus (1560) Google Scholar
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