Article thumbnail

Cardiovascular and Renal Links along the Cardiorenal Continuum

By José A. García-Donaire and Luis M. Ruilope


The cardiorenal syndrome includes the widely known relationship between kidney function and cardiovascular disease. A large number of patients have various degrees of heart and kidney dysfunction worldwide, both in developed and developing countries. Disorders affecting one of them mostly involve the other. Such interactions represent the pathogenesis for a clinical condition called cardiorenal syndrome. Renal and cardiovascular disease shares similar etiologic risk factors. The majority of vascular events are caused by accelerated atherosclerosis. Moreover, cardiovascular events rarely occur in patients without underlying disease; rather, they typically take place as the final stage of a pathophysiological process that results in progressive vascular damage, including vital organ damage, specifically the kidney and the heart if these factors are uncontrolled. Chronic kidney disease is a novel risk factor included at this stage that accelerates both vascular and cardiac damage

Topics: Review Article
Publisher: SAGE-Hindawi Access to Research
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2002). a c h t e l l
  2. (2008). a m e r s o n ,M .A .W e b e r ,G .L .B a k r i se ta l . ,“ B e n a z e p r i lp l u s amlodipine or hydrochlorothiazide for hypertension in highrisk patients,”
  3. (2001). Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals,”
  4. (2005). Anemia as a risk factor for cardiovascular disease and all-cause mortality in diabetes: the impact of chronic kidney disease,”
  5. (1994). Are renal hemodynamics a key factor in the development and maintenance of arterial hypertension
  6. (2005). Arnl¨ o v ,J .C .E v a n s ,J .B .M e i g se ta l . ,“ L o w - g r a d ea l b u m i n -uria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: the framingham heart study,”
  7. (2003). ASCOT investigators. The prevention of coronary events and stroke with atorvastatin in hypertensive subjects with average or below average cholesterol levels. The Anglo-Scandinavian Cardiac Outcomes Trial: Lipid Lowering Arm
  8. (2007). B r o w n ,R .P .C o c h r a n ,B .J .L e a v i t te ta l . ,“ M u l t i v a r i a b l e prediction of renal insufficiency developing after cardiac surgery,”
  9. (2010). Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative,”
  10. (2007). Cardiovascular disease and subsequent kidney disease,”
  11. (1996). Central role of the kidney and abnormal fluid volume control in hypertension,”
  12. (2006). Chronic kidney disease and mortality risk: a systematic review,”
  13. (2005). Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and deathintheUnitedStatesmedicarepopulation,1998to1999,” JournaloftheAmericanSocietyofNephrology,vol.16,no.2,pp.
  14. (2004). Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies,” J o u r n a lo ft h eA m e r i c a nS o c i e t yo fN e p h r o l o gy ,
  15. (2007). Chronic kidney disease: effects on the cardiovascular system,”
  16. (2006). Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease,”
  17. (2004). Development of chronic kidney disease and cardiovascular prognosis in essential hypertensive patients,”
  18. (1999). Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial,”
  19. (2000). Effects of an angiotensinconverting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients.
  20. (2001). Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy,”
  21. (1997). factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study,”
  22. (2006). Feasibility of treating prehypertension with an angiotensin-receptor blocker,”
  23. (2007). Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of
  24. (2006). H.Haller,G.C.Viberti,A.Mimranetal.,“Preventingmicroalbuminuria in patients with diabetes: rationale and design of the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study,”
  25. (2003). H.Lithell,L.Hansson,I.Skoogetal.,“TheStudyonCognition and Prognosis in the Elderly (SCOPE). Principal results of a randomised double-blind intervention trial,”
  26. Hormones and hemodynamics in heart failure,”
  27. (2002). How relevant and frequent is the presence of mild renal insufficiency in essential hypertension?”
  28. (1996). Initiation and progression of diabetic nephropathy,”
  29. (2004). K.Klausen,K.Borch-Johnsen,B.Feldt-Rasmussenetal.,“Very low levels of microalbuminuria are associated with increased riskofcoronaryheartdiseaseanddeathindependentlyofrenal function, hypertension,
  30. (2005). Kidney Disease: Improving Global Outcomes (KDIGO). Definition and classification of chronic kidney disease: a position statementInternational
  31. (1997). Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure,” Nephrology Dialysis Transplantation,v o l .1 2 ,n o .4 ,p p .
  32. (1994). Long-term influences of antihypertensive therapy on microalbuminuria in essential hypertension,”
  33. Lower progression rate of end-stage renal disease in patients with peripheral arterial disease using statins or angiotensinconverting enzyme inhibitors,”
  34. (2001). Metabolic pathogenesis of cardiorenal disease,”
  35. (2006). Microalbuminuria and chronic kidney disease as risk factors for cardiovascular disease,”NephrologyDialysisTransplantation,vol.21,no .9,pp .
  36. (1990). Microalbuminuria as predictor of increased mortality in elderly people,”
  37. (2002). Microalbuminuria in essential hypertension: redefining the threshold,”
  38. (2005). Minor abnormalities of renal function: a situation requiring integrated management of cardiovascular risk,”
  39. (2004). Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial,”
  40. (2007). Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial,”
  41. (1976). Prediction of creatinine clearance from serum creatinine,”
  42. (2000). Prevention Evaluation Study investigators, “Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus:
  43. (2003). Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition. A patient-level meta-analysis,”
  44. (2002). r u b e r g ,N .J .W e i s s m a n ,R .W a k s m a ne ta l . ,“ C o m p a r i s o n of outcomes after percutaneous coronary revascularization with stents in patients with and without mild chronic renal insufficiency,”
  45. (2008). ramipril, or both in patients at high risk for vascular events,”
  46. (2000). Randomised trial of effects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study,”
  47. (2001). Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes,”
  48. (2004). S.Hallan,A.Asberg,M.Lindberg,andH.Johnsen,“Validation of the modification of diet in renal disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay,”
  49. (2006). Telmisartan: a review of its use in the management of hypertension,”
  50. (2005). The DIabetic REtinopathy Candesartan Trials (DIRECT) Programme: baseline characteristics,”
  51. (2001). The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes,”
  52. (2007). The kidney and cardiovascular risk—implications for management: a consensus statement from the
  53. (2002). The kidney as a sensor of cardiovascular risk in essential hypertension,”
  54. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure:
  55. (2004). u g g e n e n t i ,A .F a s s i ,A .P .I l i e v ae ta l . ,“ P r e v e n t i n g microalbuminuria in type 2 diabetes,” New England
  56. (2002). Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population,”
  57. (1997). Usefulness of microalbuminuria in predicting cardiovascular mortality in treated hypertensive men with and without diabetes mellitus,”
  58. (2006). Vascular calcification and renal osteodystrophy relationship in chronic kidney disease,”