Abstract
There is increasing evidence that even mild renal dysfunction is a novel potent cardiovascular risk factor in the general elderly population. With more severe renal impairment, cardiovascular risk increases proportionately. This issue deserves attention, as chronic kidney disease (CKD) is predominantly a disease of the elderly, and the mean age of end-stage renal disease patients entering dialysis is growing constantly. In the dialysis population, when clinically significant cardiovascular disease (CVD) (particularly congestive heart failure) is present, survival is worse. Thus, every effort should be made to identify and treat cardiovascular risk factor in the early stages of CKD. However, elderly renal patients receive less proper cardiovascular therapy compared to non-renal subjects of the same age. This review deals briefly with the most significant data published in the last decade on CVD in elderly with CKD.
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References
National Institute of Diabetes and Digestive and Kidney Diseases: U.S. Renal Data System Annual Data Report (on CD). Researcher’s Guide, Reference Tables, and ADR Slides. Ann Arbor, U.S. Renal Data System Coordinating Center, 2000
RN Foley PS Parfrey MJ Sarnak (1998) ArticleTitleClinical epidemiology of cardiovascular disease in chronic renal disease Am J Kidney Dis 32 IssueIDSuppl 3 S112–9 Occurrence Handle9820470 Occurrence Handle1:STN:280:DyaK1M%2Fjs1emtA%3D%3D
H Kesteloot (2002) ArticleTitleEvolution of the mortality rate in the age class of 75–84 years worldwide Acta Cardiol 57 397–398 Occurrence Handle12542115 Occurrence Handle10.2143/AC.57.6.2005461
J Coresh BC Astor T Greene et al. (2003) ArticleTitlePrevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey Am J Kidney Dis 41 1–12 Occurrence Handle12500213 Occurrence Handle10.1053/ajkd.2003.50007
MJ Sarnak AS Levey AC Schoolwerth et al. (2003) ArticleTitleKidney 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 Occurrence Handle14581387 Occurrence Handle10.1161/01.CIR.0000095676.90936.80
D Ansell TG Feest (2000) UK Renal Registry Report 2000 UK Renal Registry Bristol, UK
F Bertoux R Gellert E Jones et al. (1998) ArticleTitleEpidemiology and demography of treated end-stage renal failure in the elderly: from European Renal Association (ERA-EDTA) Registry Nephrol Dial Transplant 13 65–68 Occurrence Handle10.1093/ndt/13.suppl_7.65
DG Oreopoulos N Dimkovic (2003) ArticleTitleGeriatric nephrology is coming of age J Am Soc Nephrol 14 1099–1101 Occurrence Handle12660346 Occurrence Handle10.1097/01.ASN.0000067656.48829.0E
CY Hsu E Vittinghoff F Lin MG Shlipak (2004) ArticleTitleThe incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency Ann Intern Med 20 IssueID41 95–101
E McGregor G Stewart RS Rodger et al. (2000) ArticleTitleEarly echocardiographic changes and survival following renal transplantation Nephrol Dial Transplant 15 93–98 Occurrence Handle10607774 Occurrence Handle1:STN:280:DC%2BD3c%2Fns1Khtg%3D%3D Occurrence Handle10.1093/ndt/15.1.93
DS Silverberg D Wexler M Blum et al. (2000) ArticleTitleThe use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations J Am Coll Cardiol 35 1737–1744 Occurrence Handle10841219 Occurrence Handle1:CAS:528:DC%2BD3cXktlGlt7Y%3D Occurrence Handle10.1016/S0735-1097(00)00613-6
MG Shlipak BM Massie (2004) ArticleTitleThe clinical challenge of cardiorenal syndrome Circulation 110 1514–1517 Occurrence Handle15381655 Occurrence Handle10.1161/01.CIR.0000143547.55093.17
PA McCullough NE Lepor (2005) ArticleTitleThe deadly triangle of anemia, renal insufficiency, and cardiovascular disease: Implications for prognosis and treatment Rev Cardiovasc Med 6 1–10 Occurrence Handle15741920 Occurrence Handle10.1016/j.carrev.2005.06.002
NS Anavekar JJ McMurray E Velazquez et al. (2004) ArticleTitleRelation between renal dysfunction and cardiovascular outcomes after myocardial infarction N Engl J Med 351 1285–1295 Occurrence Handle15385655 Occurrence Handle1:CAS:528:DC%2BD2cXnvFSgsb0%3D Occurrence Handle10.1056/NEJMoa041365
G Leoncini F Viazzi D Parodi et al. (2004) ArticleTitleMild renal dysfunction and cardiovascular risk in hypertensive patients J Am Soc Nephrol 15 IssueIDSuppl 1 S88–S90 Occurrence Handle14684681 Occurrence Handle10.1097/01.ASN.0000093245.78097.CD
RM Henry PJ Kostense G Bos et al. (2002) ArticleTitleMild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn Study Kidney Int 62 1402–1407 Occurrence Handle12234312 Occurrence Handle10.1111/j.1523-1755.2002.kid571.x
HL Hillege AR Girbes PJ Kam Particlede et al. (2000) ArticleTitleRenal function, neurohormonal activation, and survival in patients with chronic heart failure Circulation 102 203–210 Occurrence Handle10889132 Occurrence Handle1:STN:280:DC%2BD3czkvFeqtQ%3D%3D
MJ Brown CR Palmer A Castaigne et al. (2000) ArticleTitleMorbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT) Lancet 356 366–372 Occurrence Handle10972368 Occurrence Handle1:CAS:528:DC%2BD3cXls1Clu7c%3D Occurrence Handle10.1016/S0140-6736(00)02527-7
D Zeeuw Particlede G Remuzzi HH Parving et al. (2004) ArticleTitleAlbuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy Circulation 110 921–927 Occurrence Handle15302780 Occurrence Handle10.1161/01.CIR.0000139860.33974.28
B Baggio A Budakovic E Perissinotto et al. (2004) ArticleTitleAtherosclerotic risk factors and renal function in the elderly: The role of hyperfibrinogenaemia and smoking. Results from the Italian Longitudinal Study on Ageing (ILSA) Nephrol Dial Transplant 19 11–30 Occurrence Handle10.1093/ndt/gfg340
MG Shlipak LF Fried C Stehman-Breen et al. (2004) ArticleTitleChronic renal insufficiency and cardiovascular events in the elderly: Findings from the Cardiovascular Health Study Am J Geriatr Cardiol 13 81–90 Occurrence Handle15010654
MG Shlipak LF Fried C Crump et al. (2002) ArticleTitleCardiovascular disease risk status in elderly persons with renal insufficiency Kidney Int 62 997–1004 Occurrence Handle12164883 Occurrence Handle10.1046/j.1523-1755.2002.00522.x
InstitutionalAuthorNameExecutive Summary of The Third Report of The National Cholesterol Education Program (NCEP) (2001) ArticleTitleExpert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) JAMA 285 2486–2497 Occurrence Handle10.1001/jama.285.19.2486
LF Fried MG Shlipak C Crump et al. (2003) ArticleTitleRenal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals J Am Coll Cardiol 41 1364–1372 Occurrence Handle12706933 Occurrence Handle10.1016/S0735-1097(03)00163-3
P Muntner J He L Hamm et al. (2002) ArticleTitleRenal insufficiency and subsequent death resulting from cardiovascular disease in the United States J Am Soc Nephrol 13 745–753 Occurrence Handle11856780
G Manjunath H Tighiouart J Coresh et al. (2003) ArticleTitleLevel of kidney function as a risk factor for cardiovascular outcomes in the elderly Kidney Int 63 1121–1129 Occurrence Handle12631096 Occurrence Handle10.1046/j.1523-1755.2003.00838.x
MW Krause M Massing A Kshirsagar et al. (2004) ArticleTitleCombination therapy improves survival after acute myocardial infarction in the elderly with chronic kidney disease Ren Fail 26 715–725 Occurrence Handle15600265 Occurrence Handle1:CAS:528:DC%2BD2cXptlSrtrs%3D Occurrence Handle10.1081/JDI-200037110
TA Manolio RA Kronmal GL Burke et al. (1996) ArticleTitleShort-term predictors of incident stroke in older adults The Cardiovascular Health Study. Stroke 27 1479–1486 Occurrence Handle1:STN:280:BymA2sflsFc%3D
GM Chertow SL Normand BJ McNeil (2004) ArticleTitleRenalism: Inappropriately low rates of coronary angiography in elderly individuals with renal insufficiency J Am Soc Nephrol 15 2462–2468 Occurrence Handle15339996 Occurrence Handle10.1097/01.ASN.0000135969.33773.0B
LP Fried RA Kronmal AB Newman et al. (1998) ArticleTitleRisk factors for 5-year mortality in older adults: The cardiovascular health study JAMA 279 585–592 Occurrence Handle9486752 Occurrence Handle1:STN:280:DyaK1c7ks1WmtQ%3D%3D Occurrence Handle10.1001/jama.279.8.585
JS Gottdiener AM Arnold GP Aurigemma et al. (2000) ArticleTitlePredictors of congestive heart failure in the elderly: The cardiovascular health study J Am Coll Cardiol 35 1628–1637 Occurrence Handle10807470 Occurrence Handle1:STN:280:DC%2BD3c3msFOmsg%3D%3D Occurrence Handle10.1016/S0735-1097(00)00582-9
PW Leeuw ParticleDe L Thijs WH Birkenhäger et al. (2002) ArticleTitlePrognostic significance of renal function in elderly patients with isolated systolic hypertension: results from the Syst-Eur trial J Am Soc Nephrol 13 2213–2222 Occurrence Handle12191965 Occurrence Handle10.1097/01.ASN.0000027871.86296.92
RN Foley AM Murray S Li et al. (2005) ArticleTitleChronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States medicare population, 1998 to 1999 J Am Soc Nephrol 16 489–495 Occurrence Handle15590763 Occurrence Handle10.1681/ASN.2004030203
L Fried C Solomon M Shlipak et al. (2004) ArticleTitleInflammatory and prothrombotic markers and the progression of renal disease in elderly individuals J Am Soc Nephrol 15 3184–3191 Occurrence Handle15579522 Occurrence Handle10.1097/01.ASN.0000146422.45434.35
PS Parfrey (2000) ArticleTitleCardiac disease in dialysis patients: Diagnosis, burden of disease, prognosis, risk factors and management Nephrol Dial Transplant 15 IssueIDSuppl 5 58–68 Occurrence Handle11073277 Occurrence Handle10.1093/ndt/15.suppl_5.58
PS Parfrey RN Foley JD Harnett et al. (1996) ArticleTitleOutcome and risk factors of ischemic heart disease in chronic uremia Kidney Int 49 1428–1434 Occurrence Handle8731110 Occurrence Handle1:STN:280:BymB1Mfmtl0%3D
SK Munshi N Vijayakumar NA Taub et al. (2001) ArticleTitleOutcome of renal replacement therapy in the very elderly Nephrol Dial Transplant 16 128–133 Occurrence Handle11209006 Occurrence Handle1:STN:280:DC%2BD3MzjslensQ%3D%3D Occurrence Handle10.1093/ndt/16.1.128
D Joly D Anglicheau C Alberti et al. (2003) ArticleTitleOctogenarians reaching end-stage renal disease: cohort study of decision-making and clinical outcomes J Am Soc Nephrol 14 1012–1021 Occurrence Handle12660336 Occurrence Handle10.1097/01.ASN.0000054493.04151.80
WM McClellan WD Flanders RD Langston et al. (2002) ArticleTitleAnemia and renal insufficiency are independent risk factors for death among patients with congestive heart failure admitted to community hospitals: a population-based study J Am Soc Nephrol 13 1928–1936 Occurrence Handle12089390 Occurrence Handle10.1097/01.ASN.0000018409.45834.FA
DS Silverberg D Wexler D Sheps et al. (2001) ArticleTitleThe effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron: a randomized controlled study J Am Coll Cardiol 37 1775–1780 Occurrence Handle11401110 Occurrence Handle1:CAS:528:DC%2BD3MXltVGhsL8%3D Occurrence Handle10.1016/S0735-1097(01)01248-7
J Portolés A Torralbo P Martin et al. (1997) ArticleTitleCardiovascular effects of recombinant human erythropoietin in predialysis patients Am J Kidney Dis 29 541–548 Occurrence Handle9100042
T Hayashi A Suzuki T Shoji et al. (2000) ArticleTitleCardiovascular effect of normalizing the hematocrit level during erythropoietin therapy in predialysis patients with chronic renal failure Am J Kidney Dis 35 250–256 Occurrence Handle10676724 Occurrence Handle1:CAS:528:DC%2BD3cXhtFSitbY%3D
SD Roger LP McMahon A Clarkson et al. (2004) ArticleTitleEffects of early and late intervention with epoetin alpha on left ventricular mass among patients with chronic kidney disease (stage 3 or 4):Results of a randomized clinical trial J Am Soc Nephrol 15 148–156 Occurrence Handle14694167 Occurrence Handle1:CAS:528:DC%2BD2cXhs1aitQ%3D%3D Occurrence Handle10.1097/01.ASN.0000102471.89084.8B
RN Foley PS Parfrey J Morgan et al. (2000) ArticleTitleEffect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy Kidney Int 58 1325–1235 Occurrence Handle10972697 Occurrence Handle1:CAS:528:DC%2BD3cXmslehtbg%3D Occurrence Handle10.1046/j.1523-1755.2000.00289.x
PS Parfrey RN Foley BH Wittreich et al. (2005) ArticleTitleDouble-blind comparison of full and partial anemia correction in incident hemodialysis patients without symptomatic heart disease J Am Soc Nephrol 16 2180–2189 Occurrence Handle15901766 Occurrence Handle10.1681/ASN.2004121039
A Besarab WK Bolton J Browne et al. (1998) ArticleTitleThe 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 Occurrence Handle9718377 Occurrence Handle1:CAS:528:DyaK1cXlvVyrtr8%3D Occurrence Handle10.1056/NEJM199808273390903
IC Macdougall (2003) ArticleTitleCREATE: New strategies for early anaemia management in renal insufficiency Nephrol Dial Transplant 18 IssueIDSuppl 2 ii13–ii16 Occurrence Handle12819295
A Bowling (1999) ArticleTitleAgeism in cardiology BMJ 319 1353–1355 Occurrence Handle10567146 Occurrence Handle1:STN:280:DC%2BD3c%2FjsFalsw%3D%3D
J Ezekowitz FA McAlister KH Humphries et al. (2004) ArticleTitleThe association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease J Am Coll Cardiol 44 1587–1592 Occurrence Handle15489090 Occurrence Handle10.1016/j.jacc.2004.06.072
RV Freeman RH Mehta W Al Badr et al. (2003) ArticleTitleInfluence of concurrent renal dysfunction on outcomes of patients with acute coronary syndromes and implications of the use of glycoprotein IIb/IIIa inhibitors J Am Coll Cardiol 41 718–724 Occurrence Handle12628712 Occurrence Handle1:CAS:528:DC%2BD3sXisVGlsLs%3D Occurrence Handle10.1016/S0735-1097(02)02956-X
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Covic, A., Gusbeth-Tatomir, P. & Goldsmith, D.J.A. The epidemics of cardiovascular disease in elderly patients with chronic kidney disease – Two facets of the same problem. Int Urol Nephrol 38, 371–379 (2006). https://doi.org/10.1007/s11255-006-0044-z
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DOI: https://doi.org/10.1007/s11255-006-0044-z