Skip to main content
SpringerLink
Log in

Chronic Kidney Disease and Cardiovascular Risk

  • Chapter
  • First Online:
Studies in Diabetes

  • 1755 Accesses

Abstract

Chronic kidney disease (CKD) is a public health dilemma contributing to increasing global morbidity and mortality. In the USA, CKD has increased from 12.7 %, noted in the National Health and Nutrition Examination Survey (NHANES) III (1988–1994), to 15.1 % in 2009 as reported in the United States Renal Data System (USRDS) annual report based on NHANES (2003–2006) data. CKD has also been found to be an independent risk factor for cardiovascular disease (CVD). The coexistence of risk factors such as diabetes mellitus, hypertension, and dyslipidemia illustrates this relationship and is associated with a wide range of metabolic and nutritional deficiencies that directly, or indirectly, lead to CVD (Chmielewski et al., Curr Opin Lipidol 20:3–9, 2009). Our understanding of the underlying pathophysiology of CKD has evolved in the past few decades and includes common pathways for CVD. Emerging evidence supports a complex interplay of traditional and nontraditional risk factors such as metabolic abnormalities and immune mechanisms in CKD that contribute to a higher incidence of CVD. This chapter will focus on the concepts of the pathophysiology of CVD in CKD and provide up-to-date recommendations of early identification of CKD and methods to decrease CVD mortality in high-risk subjects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chmielewski M, Carrero JJ, Stenvinkel P, Lindholm B (2009) Metabolic abnormalities in chronic kidney disease that contribute to cardiovascular disease, and nutritional initiatives that may diminish the risk. Curr Opin Lipidol 20:3–9

    Article  CAS  PubMed  Google Scholar 

  2. Fried LP, Kronmal RA, Newman AB, Dild DE (1998) Risk factors for 5-year mortality in older adults: the Cardiovascular Health Study. JAMA 279:585–592

    Article  CAS  PubMed  Google Scholar 

  3. Mann JF, Gerstein HC, Pogue J, Bosch J, Yusuf S (2001) Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann Intern Med 134:629–636

    Article  CAS  PubMed  Google Scholar 

  4. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  5. Wright J, Hutchison A (2009) Cardiovascular disease in patients with chronic kidney disease. Vasc Health Risk Manag 5:713–722

    PubMed Central  PubMed  Google Scholar 

  6. Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasishe BL, Klaq MJ, Mailloux LU, Manske CL, Meyer KB, Parfrey PS, Pfeffer MA, Wenger NK, Wilson PW, Wright JT Jr (1998) Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am J Kidney Dis 32:853–906

    Article  CAS  PubMed  Google Scholar 

  7. Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:S112–S119

    Article  CAS  PubMed  Google Scholar 

  8. Dirks JH, de Zeeuw D, Agarwal SK, Alkins RC, Bennett PH, Kaseje D, Rodriquez-Hurbe B, Correa-Rotter R, El Nahas M, Katz IJ, D'Amico G, Valdes RH, Naicker S, Schieppati A, Sitthi-Amorn C, Solez K, Viberti G, Remuzzi G, Weening JT (2004) Prevention of chronic kidney and vascular disease: toward global health equity—the Bellagio 2004 Declaration. Kidney Int Suppl 98:S1–S6

    Google Scholar 

  9. Lysaght MJ (2002) Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol 13:S37–S40

    PubMed  Google Scholar 

  10. U.S. Renal Data System (2009) USRDS 2009 Annual Data Report: Atlas of end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda

    Google Scholar 

  11. National Kidney Foundation (2004) K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis 43:S1–S290

    Google Scholar 

  12. Joanne MB, Karl S (2008) Chronic kidney disease. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds) Harrison’s principles of internal medicine, Chapter 274, 17th edn. McGraw Hills, New York. http://www.accessmedicine.com/content.aspx?aID=2880823

  13. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305

    Article  CAS  PubMed  Google Scholar 

  14. Tesar V (2003) Cardiovascular complications in patients with chronic renal insufficiency and chronic kidney failure. Vnitr Lek 49:383–387

    CAS  PubMed  Google Scholar 

  15. Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164:659–663

    Article  PubMed  Google Scholar 

  16. Berl T, Henrich W (2006) Kidney-heart interactions: epidemiology, pathogenesis, and treatment. Clin J Am Soc Nephrol 1:8–18

    Article  CAS  PubMed  Google Scholar 

  17. Coresh J, Wei GL, McQuillan G, Brancati FL, Level AS, Jones C, Klaq MJ (2001) Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey (1988–1994). Arch Intern Med 161:1207–1216

    Article  CAS  PubMed  Google Scholar 

  18. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullogh PA, Kasiske BL, Kelepouris E, Klaq MJ, Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW (2003) Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation 108:2154–2169

    Article  PubMed  Google Scholar 

  19. Sarnak MJ, Levey AS (2000) Cardiovascular disease and chronic renal disease: a new paradigm. Am J Kidney Dis 35(4 Suppl 1):S117–S131

    Article  CAS  PubMed  Google Scholar 

  20. Bomback AS, Toto R (2009) Dual blockade of the renin-angiotensin-aldosterone system: beyond the ACE inhibitor and angiotensin-II receptor blocker combination. Am J Hypertens 22:1032–1040

    Article  CAS  PubMed  Google Scholar 

  21. Ruster C, Wolf G (2006) Renin-angiotensin-aldosterone system and progression of renal disease. J Am Soc Nephrol 17:2985–2991

    Article  PubMed  Google Scholar 

  22. Cohen AJ, McCarthy DM, Stoff JS (1989) Direct hemodynamic effect of insulin in the isolated perfused kidney. Am J Physiol 257:F580–F585

    CAS  PubMed  Google Scholar 

  23. Dengel DR, Goldberg AP, Mayuga RS, Kairis GM, Weir MR (1996) Insulin resistance, elevated glomerular filtration fraction, and renal injury. Hypertension 28:127–132

    Article  CAS  PubMed  Google Scholar 

  24. McFarlane SI, Banerji M, Sowers JR (2001) Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab 86:713–718

    CAS  PubMed  Google Scholar 

  25. Muntner P, He J, Chen J, Fonseca V, Whelton PK (2004) Prevalence of non-traditional cardiovascular disease risk factors among persons with impaired fasting glucose, impaired glucose tolerance, diabetes, and the metabolic syndrome: analysis of the Third National Health and Nutrition Examination Survey (NHANES III). Ann Epidemiol 14:686–695

    Article  PubMed  Google Scholar 

  26. Chen J, Muntner P, Hamm LL, Jones DW, Batuman J, Fonseca V, Whelton PK, He J (2004) The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 140:167–174

    Article  PubMed  Google Scholar 

  27. Kurella M, Lo JC, Chertow GM (2005) Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 16:2134–2140

    Article  PubMed  Google Scholar 

  28. Kahn R, Buse J, Ferrannini E, Stern M (2005) The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 28:2289–2304

    Article  PubMed  Google Scholar 

  29. Shlipak MG, Fried LF, Crump C, Bleyer AJ, Manolio TA, Tracy RP, Furberg CD, Psaty BM (2003) Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency. Circulation 107:87–92

    Article  CAS  PubMed  Google Scholar 

  30. Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE (1996) The impact of anemia on cardiomyopathy, morbidity, and mortality in end-stage renal disease. Am J Kidney Dis 28:53–61

    Article  CAS  PubMed  Google Scholar 

  31. Blacher J, Safar ME, Guerin AP, Pannier B, Marchais SJ, London GM (2003) Aortic pulse wave velocity index and mortality in end-stage renal disease. Kidney Int 63:1852–1860

    Article  PubMed  Google Scholar 

  32. Block G, Port FK (2003) Calcium phosphate metabolism and cardiovascular disease in patients with chronic kidney disease. Semin Dial 16:140–147

    Article  PubMed  Google Scholar 

  33. Ganesh SK, Stack AG, Levin NW, Hulbert-Shearon T, Port FK (2001) Association of elevated serum PO(4), Ca × PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients. J Am Soc Nephrol 12(10):2131–2138

    CAS  PubMed  Google Scholar 

  34. Block GA, Hulbert-Shearon TE, Levin NW, Port FK (1998) Association of serum phosphorus and calcium × phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis 3:607–617

    Article  Google Scholar 

  35. Jono S, McKee MD, Murry CE, Shioi A, Nishizawa Y, Mori K, Morii H, Grachelli CM (2000) Phosphate regulation of vascular smooth muscle cell calcification. Circ Res 87:E10–E17

    Article  CAS  PubMed  Google Scholar 

  36. Guerin AP, London GM, Marchais SJ, Metivier F (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021

    Article  CAS  PubMed  Google Scholar 

  37. Stevens LA, Levin A (2003) Anaemia, cardiovascular disease and kidney disease: integrating new knowledge in 2002. Curr Opin Nephrol Hypertens 12:133–138

    Article  PubMed  Google Scholar 

  38. Astor BC, Muntner P, Levin A, Eustace JA, Coresh J (2002) Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988–1994). Arch Intern Med 162:1401–1408

    Article  PubMed  Google Scholar 

  39. Hsu CY, McCulloch CE, Curhan GC (2002) Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol 13:504–510

    Article  PubMed  Google Scholar 

  40. El-Achkar TM, Ohmit SE, McCullough PA, Crook ED, Brown WW, Grimm R, Bakris GL, Keane WF, Flack JM (2005) Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney Int 67:1483–1488

    Article  PubMed  Google Scholar 

  41. McFarlane SI, Chen SC, Whaley-Connell AT, Sower JR, Vassalott JA, Salifu MO, Li S, Wang C, Bakris G, McCullough PA, Collins AJ, Norris KC (2008) Prevalence and associations of anemia of CKD: Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999–2004. Am J Kidney Dis 51:S46–S55

    Article  PubMed  Google Scholar 

  42. Portoles J, Torralbo A, Martin P, Rodrigo J, Herrero JA, Barrientos A (1997) Cardiovascular effects of recombinant human erythropoietin in predialysis patients. Am J Kidney Dis 29:541–548

    Article  CAS  PubMed  Google Scholar 

  43. Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, Reddan D (2006) Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med 355:2085–2098

    Article  CAS  PubMed  Google Scholar 

  44. Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, Feyzi JM, Ivanovich P, Kewalramani R, Levey AS, Lewis EF, McGill JB, McMurray JJ, Parfrey P, Parving HH, Remuzzi G, Singh AK, Solomon SD, Toto R (2009) A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. N Engl J Med 361:2019–2032

    Article  PubMed  Google Scholar 

  45. Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, Schwab SJ, Goodkin DA (1998) The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med 339:584–590

    Article  CAS  PubMed  Google Scholar 

  46. Foley RN, Parfrey PS, Morgan J, Barie PE, Campbell P, Cartier P, Coyle D, Fine A, Hainda P, Kingma I, Lau CY, Levin A, Mendelssohn D, Muirhead N, Murphy B, Plante RK, Posen G, Wells GA (2000) Effect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy. Kidney Int 58:1325–1335

    Article  CAS  PubMed  Google Scholar 

  47. Tepel M, van der Giet M, Statz M, Jankowski J, Zidek W (2003) The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial. Circulation 107:992–995

    Article  CAS  PubMed  Google Scholar 

  48. Potter K, Hankey GJ, Green DJ, Eikelboom JW, Arnolda LF (2008) Homocysteine or renal impairment: which is the real cardiovascular risk factor? Arterioscler Thromb Vasc Biol 28:1158–1164

    Article  CAS  PubMed  Google Scholar 

  49. Arici M, Walls J (2001) End-stage renal disease, atherosclerosis, and cardiovascular mortality: is C-reactive protein the missing link? Kidney Int 59:407–414

    Article  CAS  PubMed  Google Scholar 

  50. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH (1997) Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 336:973–979

    Article  CAS  PubMed  Google Scholar 

  51. Varagunam M, Finney H, Trevitt R, Sharples E, McCluskey DJ, Sinnott PJ, Raffery MJ, Yaqoob MM (2004) Pretransplantation levels of C-reactive protein predict all-cause and cardiovascular mortality, but not graft outcome, in kidney transplant recipients. Am J Kidney Dis 43:502–507

    Article  CAS  PubMed  Google Scholar 

  52. Noh H, Lee SW, Kang SW, Tiblier E, Sperger H, Tocchi M, Christenson R, Uretsky B (1998) Serum C-reactive protein: a predictor of mortality in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 18:387–394

    CAS  PubMed  Google Scholar 

  53. deFilippi C, Wasserman S, Rosanio S, Smiley M, Gold J, Muniz H, Badalamenti J, Herzog C, Henrich W (2003) Cardiac troponin T and C-reactive protein for predicting prognosis, coronary atherosclerosis, and cardiomyopathy in patients undergoing long-term hemodialysis. JAMA 290:353–359

    Article  CAS  PubMed  Google Scholar 

  54. Knight EL, Rimm EB, Pai JK, Rexrode KM, Cannuscio CC, Manson JE, Stampfer MJ, Curhan GC (2004) Kidney dysfunction, inflammation, and coronary events: a prospective study. J Am Soc Nephrol 15:1897–1903

    Article  PubMed  Google Scholar 

  55. Galli F, Canestrari F, Buoncristiani U (1999) Biological effects of oxidant stress in haemodialysis: the possible roles of vitamin E. Blood Purif 17:79–94

    Article  CAS  PubMed  Google Scholar 

  56. Lastra G, Manrique C, Sowers JR (2006) Obesity, cardiometabolic syndrome, and chronic kidney disease: the weight of the evidence. Adv Chronic Kidney Dis 13:365–373

    Article  PubMed  Google Scholar 

  57. Manns B, Hemmelgarn B, Tonelli M, Au F, Chiasson TC, Dong J, Klarenbach S (2010) Population based screening for chronic kidney disease: cost effectiveness study. BMJ 341:c5869

    Article  PubMed Central  PubMed  Google Scholar 

  58. Eknoyan G, Levey AS, Levin NW, Keane WF (2001) The national epidemic of chronic kidney disease. What we know and what we can do. Postgrad Med 110:23–29

    Article  CAS  PubMed  Google Scholar 

  59. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:1–266

    Google Scholar 

  60. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  CAS  PubMed  Google Scholar 

  61. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek WW, VanLente F (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247–254

    Article  CAS  PubMed  Google Scholar 

  62. Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG, Rahman M, Deysher AE, Zhang YL, Schmid CH, Levey AS (2007) Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 18:2749–2757

    Article  PubMed  Google Scholar 

  63. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612

    Article  PubMed Central  PubMed  Google Scholar 

  64. Keane WF, Eknoyan G (1999) Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 33:1004–1010

    Article  CAS  PubMed  Google Scholar 

  65. Warram JH, Gearin G, Laffel L, Krolewski AS (1996) Effect of duration of type I diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol 7:930–937

    CAS  PubMed  Google Scholar 

  66. Molitch ME, DeFronzo RA, Franz MJ, Keane WF, Mogensen CE, Parving HH, Steffes MW (2004) Nephropathy in diabetes. Diabetes Care 27:S79–S83

    Article  PubMed  Google Scholar 

  67. Weir MR (2005) The role of combination antihypertensive therapy in the prevention and treatment of chronic kidney disease. Am J Hypertens 18:100S–105S

    Article  CAS  PubMed  Google Scholar 

  68. UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853

    Article  Google Scholar 

  69. The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986

    Article  Google Scholar 

  70. Jamerson KA (2005) Preventing chronic kidney disease in special populations. Am J Hypertens 18:106S–111S

    Article  PubMed  Google Scholar 

  71. Agodoa LY, Appel L, Bakris GL, AASK Study Group (2001) Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. JAMA 285:2719–2728

    Article  CAS  PubMed  Google Scholar 

  72. Wright JT Jr, Bakris G, Greene T, AASK Study Group (2002) Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA 288:2421–2431

    Article  CAS  PubMed  Google Scholar 

  73. Flack JM, Bakris GL, McGregor J, Purkayastha D, Gatlin M, Nwose OM (2004) Safety and efficacy of combination ACE inhibitor/calcium channel blocker therapy versus ACE inhibitor monotherapy in African American patients with hypertension and type 2 diabetes. Am J Hypertens 17:180A, Abstract P-401

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, 3459 Fifth Avenue, 628 NW, Pittsburgh, PA, 15213, USA

    Jaya P. Buddenini

  2. Divisions of Clinical Medicine and Nephrology, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, 65201, USA

    Kunal Chaudhary

  3. Division of Endocrinology, Diabetes Center, University Hospital, Columbia, MO, 65212, USA

    James R. Sowers (Thomas W. and Joan F. Burns Missouri Chair in Diabetes, Director of the MU Diabetes and Cardiovascular Center, Director)

  4. Harry S. Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO, 65201, USA

    Adam Whaley-Connell

  5. Division of Nephrology and Hypertension, University of Missouri-Columbia School of Medicine, 800 Hospital Drive, Columbia, MO, 65201, USA

    Adam Whaley-Connell

Authors
  1. Jaya P. Buddenini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kunal Chaudhary
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James R. Sowers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adam Whaley-Connell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adam Whaley-Connell .

Editor information

Editors and Affiliations

  1. Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA

    Irina Obrosova

  2. Centre for Endocrinology and Metabolism, University of Brimingham, School of Clinical and Experimental Medicine, Birmingham, United Kingdom

    Martin J. Stevens

  3. Veterans Affairs Medical Center, University of Iowa, Iowa City, Iowa, USA

    Mark A. Yorek

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Buddenini, J.P., Chaudhary, K., Sowers, J.R., Whaley-Connell, A. (2014). Chronic Kidney Disease and Cardiovascular Risk. In: Obrosova, I., Stevens, M., Yorek, M. (eds) Studies in Diabetes. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4899-8035-9_4

Download citation

Publish with us

Policies and ethics

Search

Navigation