Abstract
Chronic kidney disease (CKD) is associated with premature cardiovascular morbidity
and mortality. Traditional Framingham risk factors contribute partially to the malignant
form of cardiovascular disease in CKD. Uremic-specific risk factors including chronic
inflammation, retention of uremic toxins, and abnormal bone mineral metabolism have
independently been linked to the pathogenesis of premature vascular aging, atherosclerosis,
and cardiovascular disease. In this review we explore the mechanisms by which premature
aging occurs in CKD through its pathologic effects on cardiovascular health, and the
determinants of cardiac disease in patients with CKD. We outline strategies for prevention
and therapeutic interventions in this vulnerable population.
Résumé
L’insuffisance rénale chronique (IRC) est associée à une morbidité et à une mortalité
cardiovasculaires prématurées. Les facteurs de risque classiques définis dans le cadre
de l’étude de Framingham contribuent en partie à la forme maligne des maladies cardiovasculaires
chez les patients atteints d’IRC. Des facteurs de risque urémiques, notamment l’inflammation
chronique, la rétention de toxines urémiques et un métabolisme minéral osseux anormal,
ont été liés indépendamment à la pathogenèse du vieillissement vasculaire prématuré,
de l’athérosclérose et des maladies cardiovasculaires. Dans le présent article, nous
examinons les mécanismes par lesquels le vieillissement prématuré se produit en présence
d’IRC à la suite de ses effets pathologiques sur la santé cardiovasculaire. Nous abordons
aussi les déterminants des cardiopathies chez les patients atteints d’IRC. Nous exposons
les grandes lignes de stratégies de prévention et d’interventions thérapeutiques applicables
au sein de cette population vulnérable.
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Article info
Publication history
Published online: May 24, 2019
Accepted:
May 16,
2019
Received:
March 11,
2019
Footnotes
See page 1185 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
