J Nephropathol. 2019;8(2): e17.
doi: 10.15171/jnp.2019.17
  Abstract View: 308
  PDF Download: 250

Review Article

Vascular dysfunction and atherosclerosis in chronic kidney disease; A distinct entity

Eranga Harshani Silva 1 * , Chandima Madhu Wickramatilake 2, Sarath Lekamwasam 3, Lakmini Kumari Boralugoda Mudduwa 4, Ranjuka Arushana Ubayasiri 5

1 Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka
2 Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
3 Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
4 Department of Pathology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
5 Teaching Hospital, Karapitiya, Galle, Sri Lanka

Abstract

Cardiovascular disease (CVD) is prevalent among patients with chronic kidney disease (CKD) and its occurrence and severity cannot be fully defined by the conventional cardiovascular risk factors namely age, hypertension, dyslipidaemia, diabetes mellitus and obesity. Contemporary studies have examined the role of non-conventional risk factors such as anemia, hyperhomocysteinemia, calcium and phosphate metabolism, vascular stiffness due to endothelial dysfunction ( ED), oxidative injury, and inflammation in the causation of CVD in CKD. Therapeutic interventions used in non-CKD patients are found to be less effective on patients with CKD. The purpose of this review was to gather available evidence on the CVD risk among CKD patients. Numerous mechanisms have been postulated to describe the increased atherogenicity in CKD patients. We discuss these mechanisms especially arterial stiffness, ED and inflammation in detail. In conclusion, CVD in CKD is still an unexplored area which needs further studies to uncover the possible mechanisms. Identifying newer therapies to improve health among this group of patients is of paramount importance.

Implication for health policy/practice/research/medical education:

Summarizing the available literature on the increased cardiovascular risk and postulated mechanisms among patients with chronic kidney disease guides the future researchers. Revealing new mechanisms or risk factors may have a significant impact on the healthcare management and policy.

Please cite this paper as: Silva EH, Wickramatilake CM, Lekamwasam S, Mudduwa LKB, Ubayasiri RA. Vascular dysfunction and atherosclerosis in chronic kidney disease; A distinct entity. J Nephropathol. 2019;8(2):e17. DOI: 10.15171/jnp.2019.17.

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Submitted: 02 Nov 2018
Accepted: 29 Jan 2019
First published online: 28 Feb 2019
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