Detection of Atherosclerotic Cardiovascular Disease in Patients with Advanced Chronic Kidney Disease in the Cardiology and Nephrology Communities

Rafia I. Chaudhry, Roy O. Mathew, Mandeep S. Sidhu, Preety Sidhu-Adler, Radmila Lyubarova, Janani Rangaswami, Loay Salman, Arif Asif, Jerome L. Fleg, Peter A. McCullough, Frank Maddux, Sripal Bangalore

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality among patients with chronic kidney disease (CKD) with a glomerular filtration rate of < 60 mL/min/1.73 m 2 body surface area. The availability of high-quality randomized controlled trial data to guide management for the population with CKD and ASCVD is limited. Understanding current practice patterns among providers caring for individuals with CKD and CVD is important in guiding future trial questions. Methods: A qualitative survey study was performed. An electronic survey regarding the diagnosis and management of CVD in patients with CKD was conducted using a convenience sample of 450 practicing nephrology and cardiology providers. The survey was administered using Qualtrics® (https://www.qualtrics.com). Results: There were a total of 113 responses, 81 of which were complete responses. More than 90% of the respondents acknowledged the importance of CVD as a cause of morbidity and mortality in patients with CKD. Outside the kidney transplant evaluation setting, 5% of the respondents would screen an asymptomatic patient with advanced CKD for ASCVD. Outside the kidney transplant evaluation scenario, the respondents did not opt for invasive management strategies in advanced CKD. Conclusions: The survey results reveal a lack of consensus among providers caring for patients with advanced CKD about the management of ASCVD in this setting. Future randomized controlled trials will be needed to better inform the clinical management of ASCVD in these patients. The limitations of the study include its small sample size and the relatively low response rate among the respondents.

Original languageEnglish (US)
Pages (from-to)285-295
Number of pages11
JournalCardioRenal Medicine
Volume8
Issue number4
DOIs
StatePublished - Oct 1 2018

Keywords

  • Atherosclerotic cardiovascular disease
  • Chronic kidney disease
  • Coronary artery disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Urology

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