[Renal insufficiency and cardiovascular diseases].

Chronic kidney disease (CKD) is a strong cardiovascular risk factor. Microalbuminuria is an early indicator of renal and cardiac damage. Optimal blood pressure therapy and reduction of proteinuria are important measures in order to reduce increased cardiovascular morbidity and mortality in this cohort. Secondary prevention by optimal medical as well as interventional therapy is employed in an inadequate number of CKD patients. In addition, CKD patients should be screened for sleep-related disorders and, if required, adequate therapy should be provided in order to improve cardiovascular outcome. Prospective data in advanced CKD patients concerning new therapeutical approaches such as oral factor Xa- or thrombin-inhibitor therapy are lacking. Optimal treatment of atrial fibrillation in dialysis patients with vitamin K antagonists is also unclear. Prospective studies of transcatheter aortic valve implantation for severe aortic stenosis in patients with advanced stages of renal insufficiency or dialysis therapy are still missing.