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Heart and kidney disease: a cardiovascular high-risk constellation

Herz- und Nierenerkrankung: eine kardiovaskuläre Hochrisikokonstellation

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Abstract

Chronic kidney disease (CKD) is associated with substantial cardiovascular morbidity and mortality. This is mediated by highly prevalent traditional cardiovascular risk factors such as arterial hypertension and diabetes mellitus in patients with CKD, but also by the presence of CKD-specific so-called nontraditional cardiovascular risk factors such as vascular calcification, uremic toxins, uremic dyslipidemia, inflammation, and oxidative stress. Therefore, the primary and secondary prevention of cardiovascular disease represents an important part of the care of patients with CKD. This entails optimal control of blood pressure and diabetes, treatment of the uremic dyslipidemia, as well as life-style modifying factors such as weight reduction and smoking cessation.

Zusammenfassung

Die chronische Nierenerkrankung ist mit einer erheblichen kardiovaskulären Morbidität und Mortalität assoziiert. Ursächlich hierfür ist zum einen die hohe Prävalenz traditioneller kardiovaskulärer Risikofaktoren wie arterielle Hypertonie und Diabetes mellitus bei Nierenkranken und zum anderen niereninsuffizienzspezifische, sog. nichttraditionelle kardiovaskuläre Risikofaktoren. Hierzu gehören vaskuläre Kalzifikation, Urämietoxine, die urämische Dyslipidämie sowie Inflammation und oxidativer Stress. Deshalb kommt der Primär- und Sekundärprävention kardiovaskulärer Erkrankungen in der Nephrologie eine zentrale Rolle zu. Hierzu gehören eine optimale Blutdruck- und Blutzuckereinstellung, die Therapie der urämischen Dyslipidämie sowie lebensstilmodifizierende Faktoren wie Gewichtsreduktion und Nikotinkarenz.

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Authors and Affiliations

  1. Klinik für Innere Medizin IV, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany

    Stefan J. Schunk, Thimoteus Speer & Danilo Fliser

  2. Translationale Kardio-Renale Medizin, Universität des Saarlandes, Homburg/Saar, Germany

    Thimoteus Speer

  3. Klinik für Innere Medizin IV, Nieren- und Hochdruckkrankheiten, Universitätsklinikum des Saarlandes, Kirrberger Straße, Gebäude 41, 66421, Homburg/Saar, Germany

    Stefan J. Schunk

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  1. Stefan J. Schunk
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Correspondence to Stefan J. Schunk.

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S.J. Schunk, T. Speer and D. Fliser declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Schunk, S.J., Speer, T. & Fliser, D. Heart and kidney disease: a cardiovascular high-risk constellation. Herz 46, 206–211 (2021). https://doi.org/10.1007/s00059-020-05012-z

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