Recognizing the link between chronic kidney disease and cardiovascular disease.

The prevalence of chronic kidney disease (CKD) is rising in the United States, and cardiovascular disease (CVD) is increasingly recognized to occur at elevated rates in patients with CKD compared with the general population. The impact of CVD in patients with CKD is significant, inversely related to the level of kidney function, and exaggerated when compared with matched patients without CKD. CKD is associated with an increased risk of CVD, CVD events, and death, but the prevalence of traditional CVD risk factors is also increased compared with the general population. Proteinuria, hypertension, dyslipidemia, and diabetes are common in patients with CKD and contribute directly to CVD events. CKD-related factors (eg, disorders of electrolyte and mineral metabolism, anemia, and vascular calcification) also contribute to mortality associated with CKD.