Saeed Danish, Reza Taufiqa, Shahzad Muhammad Waqas, Karim Mandokhail Alishba, Bakht Danyal, Qizilbash Farwa Haider, Silloca-Cabana Elizabeth O, Ramadhan Afif, Bokhari Syed Faqeer Hussain
Internal Medicine, Shaikh Zayed Medical Complex, Lahore, PAK.
Internal Medicine, Avalon University School of Medicine, Youngstown, USA.
Cureus. 2023 Dec 30;15(12):e51362. doi: 10.7759/cureus.51362. eCollection 2023 Dec.
Chronic Kidney Disease (CKD) has emerged as a global healthcare challenge affecting a significant portion of the world's population. This comprehensive narrative review delves into the intricate relationship between CKD and cardiovascular disease (CVD). CKD is characterized by kidney damage persisting for at least three months, often with or without a decline in glomerular filtration rate (GFR). It is closely linked with CVD, as individuals with CKD face a high risk of cardiovascular events, making cardiovascular-associated mortality a significant concern in advanced CKD stages. The review emphasizes the importance of precise risk assessment using biomarkers, advanced imaging, and tailored medication strategies to mitigate cardiovascular risks in CKD patients. Lifestyle modifications, early intervention, and patient-centered care are crucial in managing both conditions. Challenges in awareness and recognition of CKD and the need for comprehensive interdisciplinary care are highlighted. Recent advances in research offer promising therapies, such as SGLT2 inhibitors, MRAs, GLP-1R agonists, and selective endothelin receptor antagonists. Stem cell-based therapies, gene editing, and regenerative approaches are under investigation. Patient-physician "risk discussions" and tailored risk assessments are essential for improving patient outcomes. In conclusion, the review underscores the complexity of the interconnected CKD and cardiovascular health domains. Ongoing research, innovative therapies, and personalized healthcare will be instrumental in addressing the challenges, reducing the disease burden, and enhancing well-being for individuals facing CKD and cardiovascular issues. Recognizing the intricate connections between these conditions is imperative for healthcare providers, policymakers, and researchers as they seek to improve the quality of care and outcomes for affected individuals.
慢性肾脏病（CKD）已成为一项全球性的医疗挑战，影响着世界上很大一部分人口。这篇全面的叙述性综述深入探讨了CKD与心血管疾病（CVD）之间的复杂关系。CKD的特征是肾脏损伤持续至少三个月，通常伴有或不伴有肾小球滤过率（GFR）下降。它与CVD密切相关，因为CKD患者面临心血管事件的高风险，这使得心血管相关死亡率成为晚期CKD阶段的一个重大问题。该综述强调了使用生物标志物、先进成像技术进行精确风险评估以及制定个性化药物治疗策略以降低CKD患者心血管风险的重要性。生活方式的改变、早期干预和以患者为中心的护理对于管理这两种疾病至关重要。文中强调了CKD认识和识别方面的挑战以及对全面跨学科护理的需求。研究的最新进展提供了有前景的治疗方法，如钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂、盐皮质激素受体拮抗剂（MRAs）、胰高血糖素样肽-1受体激动剂（GLP-1R）和选择性内皮素受体拮抗剂。基于干细胞的疗法、基因编辑和再生方法正在研究中。患者与医生之间的“风险讨论”和个性化风险评估对于改善患者预后至关重要。总之，该综述强调了CKD与心血管健康这两个相互关联领域的复杂性。正在进行的研究、创新疗法和个性化医疗将有助于应对挑战、减轻疾病负担并提高面临CKD和心血管问题的个体的福祉。认识到这些疾病之间的复杂联系对于医疗服务提供者、政策制定者和研究人员来说至关重要，因为他们致力于提高受影响个体的护理质量和治疗效果。
