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J Am Coll Cardiol, 2003; 41:725-728, doi:10.1016/S0735-1097(02)02955-8
© 2003 by the American College of Cardiology Foundation
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Why is chronic kidney disease the "spoiler" for cardiovascular outcomes?*

Peter A. McCullough, MD, MPH, FACC, FACP, FCCP, FAHA*,*

* Departments of Basic Science and Internal Medicine, Cardiology Section, University of Missouri-Kansas City School of Medicine, Truman Medical Center, Kansas City, Missouri, USA



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  		Figure 1 The classification of chronic kidney disease (CKD) according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Increased rates of adverse effects are generally seen below an estimated glomerular filtration rate of 60 ml/min/1.73 m2. CHF = congestive heart failure; CV = cardiovascular; ESRD = end-stage renal disease; GFR = glomerular filtration rate; MI = myocardial infarction. Adapted from reference 3.

 


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  		Figure 2 Freedom from cardiovascular death after angioplasty or bypass surgery in the Bypass Angioplasty Revascularization Investigation (BARI) Trial and Registry, n = 3,608. CKD = chronic kidney disease; DM = diabetes mellitus. Adapted from reference 7.

 


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  		Figure 3 The unique pathobiology of the chronic kidney disease (CKD) state and its effects on the cardiovascular system. Ca = calcium; HDL = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; Lp(a) = lipoprotein (a); LPL = lipoprotein lipase; LV = left ventricle; PO4 = phosphorus; PTH = parathyroid hormone; RAS = renin angiotensin system; SNS = sympathetic nervous system; TG = triglycerides.

 




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