Cardiovascular Issues and Renal Disease

The increasing prevalence of both chronic kidney disease (CKD) and cardiovascular disease requires a better understanding by physicians in practice. The regular emergence of newer data continues to support the unique and complex interaction between the kidney and the heart. CKD has been associated with increased risk of in-hospital death and major bleeding in patients with acute coronary syndromes (ACS). A higher level of risk stratification is required for these patients. Contrast-induced acute kidney injury requires a comprehensive management strategy in patients receiving percutaneous therapy for ACS. Patients with CKD are susceptible to cardiorenal syndromes which complicate bidirectional organ dysfunction and are particularly challenging to manage. Treatment and prevention methods continue to be adjusted to better incorporate the new improvements and recommendations in everyday clinical practice. In light of newer guidelines, nephrologists and cardiologists must work in tandem for better diagnosis and management. Imaging and laboratory diagnostic testing are now being utilized with better insight pertinent to each disease process. Medications and dosages must be adjusted with respect to the underlying physiology and pathophysiology of the two entities. Certain cardiovascular diseases (VHD, arrhythmias, PAD) are being looked at from a different angle, hoping for improvements in therapies. Further advances in the understanding of pathophysiological mechanisms at work in patients with CKD will continue to lead to new diagnostic and therapeutic targets in this high-risk population.