Cardiovascular risk in patients with chronic kidney disease
Dec 3, 2024
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Mark Sarnak, an expert from Tufts University, discusses the intricate relationship between chronic kidney disease (CKD) and cardiovascular risks. He highlights the rising incidence of CKD driven by obesity and diabetes, and the significance of efficient screening. Sarnak delves into the latest guidelines for managing cardiovascular risk in CKD patients, including the use of innovative treatments like SGLT2 inhibitors. He also touches on the complexities of prescribing antiplatelet medications and the future of personalized medicine in cardiovascular care.
Chronic kidney disease significantly increases cardiovascular risk, necessitating urgent awareness and better screening strategies for early detection.
Current treatment options like SGLT2 inhibitors and RAS blockade are essential in managing patients with both chronic kidney disease and cardiovascular issues.
Deep dives
Prevalence and Impact of Chronic Kidney Disease
Chronic kidney disease (CKD) affects approximately 10 to 15% of the population globally, with a significant rise over the past few decades due to obesity, diabetes, and aging. CKD is often silent, meaning many cases go undetected without proper screening strategies. The prevalence of CKD is estimated to be around 700 to 800 million people worldwide. Importantly, the presence of CKD significantly increases the risk of cardiovascular disease independent of other risk factors, highlighting the urgency for awareness and detection.
Risk Factors and Mechanisms Linking CKD and Cardiovascular Disease
The relationship between CKD and cardiovascular disease is strong, with a graded increase in risk as kidney function declines. Both decreased glomerular filtration rate (GFR) and increased albuminuria are robust risk factors for developing cardiovascular issues, including coronary disease and heart failure. Various mechanisms contribute to this increased risk, including both traditional cardiovascular risk factors and non-traditional factors unique to CKD patients, such as inflammation and mineral metabolism abnormalities. Understanding these mechanisms is crucial for developing comprehensive strategies in managing patients at risk.
Management Strategies for CKD Patients at Risk of Cardiovascular Disease
Identifying patients with CKD and established cardiovascular risk involves utilizing treatments that have shown benefits in both areas. Medications such as SGLT2 inhibitors and RAS blockade are recommended for patients with elevated albumin levels to help prevent the progression of both kidney and cardiovascular disease. There is ongoing research into various new therapeutic agents and personalized medicine approaches, which aim to determine the most effective treatment for individual patients. This evolving landscape of management options underscores the importance of targeted screening and medication strategies in improving patient outcomes.
In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Mark Sarnak from Tufts University in Boston. They discuss all aspects of cardiovascular risk in chronic kidney disease patients including how to mitigate the risk and future therapeutic areas. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 or wherever you get your podcasts - it's really helpful.
This podcast was funded by the Boehringer Ingelheim and Lilly Alliance. The sponsor had no influence over the podcast content, including the selection of speakers or the approval of this episode.
After you've listened to the episode, test your understanding of the topic by taking the free self-assessment module hosted on BMJ Learning at https://new-learning.bmj.com/course/30000268.
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