Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease.
Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia –related processes.
This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.
Tabella dei contenuti
Chronic Kidney Disease and Cardiovascular Disease Interrelationships.- Links between Chronic Kidney Disease and Cardiovascular Disease: A Bidirectional Relationship.- Cardiorenal versus Renocardiac Syndrome.- Crosstalk between the Cardiovascular System and the Kidney.- Non-Pressure-Related Deleterious Effects of Excessive Dietary Sodium.- Regulation of Vascular and Renal Cells by Common Mediators in Health and Disease: Role of the Renin—Angiotensin System in the Pathophysiology of Hypertension and Cardiovascular Disease.- Chronic Kidney Disease as a Risk for Cardiovascular Disease.- Cardiorenal Continuum.- Definition and Classification of Stages of Chronic Kidney Disease: Screening for Chronic Kidney Disease.- Cardiovascular Disease Risk Factors in Chronic Kidney Disease: Traditional, Nontraditional, and Uremia-related Threats.- Increased Levels of Urinary Albumin: A Cardiovascular Risk Factor and a Target for Treatment.- Microalbuminuria and Kidney Disease: An Evidence-based Perspective.- Cardiometabolic Syndrome.- Diabetes Mellitus: Is the Presence of Nephropathy Important as a Cardiovascular Risk Factor for Cardioneral Syndrome?.- Spectrum of Cardiovascular Disease in Chronic Kidney Disease.- Cardiovascular Disease: Coronary Artery Disease and Coronary Artery Calcification.- Cardiomyopathy in Chronic Kidney Disease and in End-stage Renal Disease.- Pathophysiological Mechanisms and Prognostic Significance of Renal Functional Impairment in Cardiac Patients.- Stroke.- Mechanisms of Cardiovascular Complications.- Uremic Toxins.- Endothelial Dysfunction, Nitric Oxide Bioavailability, and Asymmetric Dimethyl Arginine.- Pathophysiologic Link between Atherosclerosis and Nephrosclerosis.- Aortic Stiffness, Kidney Disease, and Renal Transplantation.- Disturbed Calcium-Phosphorus Metabolism/Arterial Calcifications: Consequences on Cardiovascular Function and Clinical Outcome.- Role of Neurohormonal Activation in the Pathogenesis of Cardiovascular Complications in Chronic Kidney Disease.- Impaired Autonomic Blood Pressure and Blood Volume Control in Chronic Renal Failure.- Role of Novel Biomarkers in Chronic Kidney Disease: Urotensin II.- Role of Novel Biomarkers in Chronic Kidney Disease: Renalase.- Regression/Progression of Chronic Kidney Disease.- Diabetic Kidney Disease.- Nondiabetic Kidney Disease.- Therapeutic Modalities.- Approaches in the Management of Patients with Chronic Kidney Disease and Cardiovascular Disease.- Trends in the Management of Cardiac Patients with Renal Functional Impairment.
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