Cardiovascular risk in patients with chronic kidney diseases: a time for new risk markers?

The number of patients with end-stage renal disease who need expensive dialysis treatment or transplantation is increasing all over the world. Therefore, new possibilities of prevention and treatment of chronic kidney diseases (CKD) are being looked for. However, patients with CKD represent a population not only at risk for progression to renal failure, but also at even greater risk for cardiovascular (CV) diseases. Extreme CV morbidity and mortality in dialysed patients is well-known, but recent studies stress a high CV risk even at early stage of CKD. Impaired renal function and/or albuminuria are now considered major CV risk factors. The reasons for this are not only a high prevalence of traditional CV risk factors in CKD patients or their insufficient treatment, but also the presence of non-traditional CV risk factors that could be specific for CKD. Some of these novel risk factors, particularly markers of inflammation, endothelial function, hemocoagulation and fibrinolysis are discussed, and their significance in the prediction of CV and renal outcome examined (Tab. 1, Ref 57).