Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention

Mark J. Sarnak, Andrew S. Levey, Anton C. Schoolwerth, Josef Coresh, Bruce Culleton, L. Lee Hamm, Peter A. McCullough, Bertram L. Kasiske, Ellie Kelepouris, Michael J. Klag, Patrick Parfrey, Marc Pfeffer, Leopoldo Raij, David J. Spinosa, Peter W. Wilson

Research output: Contribution to journalArticle

772 Citations (Scopus)

Abstract

There is a high prevalence of CVD in subjects with CKD. The presence of CKD, whether it is manifested by proteinuria (albuminuria) or reduced GFR, appears to be an independent risk factor for CVD outcomes, particularly in higher-risk populations. These findings are consistent with the NKF task force recommendation that patients with CKD should be considered in the highest-risk group for CVD events. The seventh report of the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7) includes CKD as a "compelling" indication, justifying lower target blood pressure and treatment with specific antihypertensive agents. Similarly, the recently published "NKF-K/DOQI Clinical Practice Guidelines on Managing Dyslipidemia in Chronic Kidney Disease" recommend that all patients with CKD be included in the highest-risk group, justifying a lower target low-density lipoprotein cholesterol level. By contrast, the third report of the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) does not include CKD in the list of high-risk conditions necessitating more aggressive management. We suggest that the National Cholesterol Education Program and other groups include CKD in the highest-risk group for recommendations for prevention, detection, and treatment of CVD risk factors. In addition, these findings reinforce the recent recommendation from the NKF on the importance of early identification and treatment of CKD and its associated comorbid conditions. We suggest that the routine evaluation of patients with CVD or those at high risk for CVD include measurement of spot urine albumin-to-creatinine ratio or total protein-to-creatinine ratio and estimation of GFR by serum creatinine and prediction equations. Finally, there is an urgent need for additional randomized controlled studies to evaluate potential treatments of CVD in CKD.

Original languageEnglish
Pages (from-to)1050-1065
Number of pages16
JournalHypertension
Volume42
Issue number5
DOIs
StatePublished - Nov 1 2003
Externally publishedYes

Fingerprint

Kidney Diseases
Cardiology
Epidemiology
Cardiovascular Diseases
Hypertension
Kidney
Research
Creatinine
Therapeutics
Cholesterol
Education
Albuminuria
Advisory Committees
Dyslipidemias
Chronic Renal Insufficiency
Proteinuria
Practice Guidelines
LDL Cholesterol
Antihypertensive Agents
Albumins

Keywords

  • AHA Scientific Statements
  • Cardiovascular diseases
  • Kidney
  • Risk factors

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease : A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. / Sarnak, Mark J.; Levey, Andrew S.; Schoolwerth, Anton C.; Coresh, Josef; Culleton, Bruce; Hamm, L. Lee; McCullough, Peter A.; Kasiske, Bertram L.; Kelepouris, Ellie; Klag, Michael J.; Parfrey, Patrick; Pfeffer, Marc; Raij, Leopoldo; Spinosa, David J.; Wilson, Peter W.

In: Hypertension, Vol. 42, No. 5, 01.11.2003, p. 1050-1065.

Research output: Contribution to journalArticle

Sarnak, MJ, Levey, AS, Schoolwerth, AC, Coresh, J, Culleton, B, Hamm, LL, McCullough, PA, Kasiske, BL, Kelepouris, E, Klag, MJ, Parfrey, P, Pfeffer, M, Raij, L, Spinosa, DJ & Wilson, PW 2003, 'Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention', Hypertension, vol. 42, no. 5, pp. 1050-1065. https://doi.org/10.1161/01.HYP.0000102971.85504.7c
Sarnak, Mark J. ; Levey, Andrew S. ; Schoolwerth, Anton C. ; Coresh, Josef ; Culleton, Bruce ; Hamm, L. Lee ; McCullough, Peter A. ; Kasiske, Bertram L. ; Kelepouris, Ellie ; Klag, Michael J. ; Parfrey, Patrick ; Pfeffer, Marc ; Raij, Leopoldo ; Spinosa, David J. ; Wilson, Peter W. / Kidney Disease as a Risk Factor for Development of Cardiovascular Disease : A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. In: Hypertension. 2003 ; Vol. 42, No. 5. pp. 1050-1065.
@article{1cca767cccb048a180986816966578ab,
title = "Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention",
abstract = "There is a high prevalence of CVD in subjects with CKD. The presence of CKD, whether it is manifested by proteinuria (albuminuria) or reduced GFR, appears to be an independent risk factor for CVD outcomes, particularly in higher-risk populations. These findings are consistent with the NKF task force recommendation that patients with CKD should be considered in the highest-risk group for CVD events. The seventh report of the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7) includes CKD as a {"}compelling{"} indication, justifying lower target blood pressure and treatment with specific antihypertensive agents. Similarly, the recently published {"}NKF-K/DOQI Clinical Practice Guidelines on Managing Dyslipidemia in Chronic Kidney Disease{"} recommend that all patients with CKD be included in the highest-risk group, justifying a lower target low-density lipoprotein cholesterol level. By contrast, the third report of the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) does not include CKD in the list of high-risk conditions necessitating more aggressive management. We suggest that the National Cholesterol Education Program and other groups include CKD in the highest-risk group for recommendations for prevention, detection, and treatment of CVD risk factors. In addition, these findings reinforce the recent recommendation from the NKF on the importance of early identification and treatment of CKD and its associated comorbid conditions. We suggest that the routine evaluation of patients with CVD or those at high risk for CVD include measurement of spot urine albumin-to-creatinine ratio or total protein-to-creatinine ratio and estimation of GFR by serum creatinine and prediction equations. Finally, there is an urgent need for additional randomized controlled studies to evaluate potential treatments of CVD in CKD.",
keywords = "AHA Scientific Statements, Cardiovascular diseases, Kidney, Risk factors",
author = "Sarnak, {Mark J.} and Levey, {Andrew S.} and Schoolwerth, {Anton C.} and Josef Coresh and Bruce Culleton and Hamm, {L. Lee} and McCullough, {Peter A.} and Kasiske, {Bertram L.} and Ellie Kelepouris and Klag, {Michael J.} and Patrick Parfrey and Marc Pfeffer and Leopoldo Raij and Spinosa, {David J.} and Wilson, {Peter W.}",
year = "2003",
month = "11",
day = "1",
doi = "10.1161/01.HYP.0000102971.85504.7c",
language = "English",
volume = "42",
pages = "1050--1065",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Kidney Disease as a Risk Factor for Development of Cardiovascular Disease

T2 - A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention

AU - Sarnak, Mark J.

AU - Levey, Andrew S.

AU - Schoolwerth, Anton C.

AU - Coresh, Josef

AU - Culleton, Bruce

AU - Hamm, L. Lee

AU - McCullough, Peter A.

AU - Kasiske, Bertram L.

AU - Kelepouris, Ellie

AU - Klag, Michael J.

AU - Parfrey, Patrick

AU - Pfeffer, Marc

AU - Raij, Leopoldo

AU - Spinosa, David J.

AU - Wilson, Peter W.

PY - 2003/11/1

Y1 - 2003/11/1

N2 - There is a high prevalence of CVD in subjects with CKD. The presence of CKD, whether it is manifested by proteinuria (albuminuria) or reduced GFR, appears to be an independent risk factor for CVD outcomes, particularly in higher-risk populations. These findings are consistent with the NKF task force recommendation that patients with CKD should be considered in the highest-risk group for CVD events. The seventh report of the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7) includes CKD as a "compelling" indication, justifying lower target blood pressure and treatment with specific antihypertensive agents. Similarly, the recently published "NKF-K/DOQI Clinical Practice Guidelines on Managing Dyslipidemia in Chronic Kidney Disease" recommend that all patients with CKD be included in the highest-risk group, justifying a lower target low-density lipoprotein cholesterol level. By contrast, the third report of the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) does not include CKD in the list of high-risk conditions necessitating more aggressive management. We suggest that the National Cholesterol Education Program and other groups include CKD in the highest-risk group for recommendations for prevention, detection, and treatment of CVD risk factors. In addition, these findings reinforce the recent recommendation from the NKF on the importance of early identification and treatment of CKD and its associated comorbid conditions. We suggest that the routine evaluation of patients with CVD or those at high risk for CVD include measurement of spot urine albumin-to-creatinine ratio or total protein-to-creatinine ratio and estimation of GFR by serum creatinine and prediction equations. Finally, there is an urgent need for additional randomized controlled studies to evaluate potential treatments of CVD in CKD.

AB - There is a high prevalence of CVD in subjects with CKD. The presence of CKD, whether it is manifested by proteinuria (albuminuria) or reduced GFR, appears to be an independent risk factor for CVD outcomes, particularly in higher-risk populations. These findings are consistent with the NKF task force recommendation that patients with CKD should be considered in the highest-risk group for CVD events. The seventh report of the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7) includes CKD as a "compelling" indication, justifying lower target blood pressure and treatment with specific antihypertensive agents. Similarly, the recently published "NKF-K/DOQI Clinical Practice Guidelines on Managing Dyslipidemia in Chronic Kidney Disease" recommend that all patients with CKD be included in the highest-risk group, justifying a lower target low-density lipoprotein cholesterol level. By contrast, the third report of the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) does not include CKD in the list of high-risk conditions necessitating more aggressive management. We suggest that the National Cholesterol Education Program and other groups include CKD in the highest-risk group for recommendations for prevention, detection, and treatment of CVD risk factors. In addition, these findings reinforce the recent recommendation from the NKF on the importance of early identification and treatment of CKD and its associated comorbid conditions. We suggest that the routine evaluation of patients with CVD or those at high risk for CVD include measurement of spot urine albumin-to-creatinine ratio or total protein-to-creatinine ratio and estimation of GFR by serum creatinine and prediction equations. Finally, there is an urgent need for additional randomized controlled studies to evaluate potential treatments of CVD in CKD.

KW - AHA Scientific Statements

KW - Cardiovascular diseases

KW - Kidney

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=0242441465&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0242441465&partnerID=8YFLogxK

U2 - 10.1161/01.HYP.0000102971.85504.7c

DO - 10.1161/01.HYP.0000102971.85504.7c

M3 - Article

C2 - 14604997

AN - SCOPUS:0242441465

VL - 42

SP - 1050

EP - 1065

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 5

ER -