The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions
Background: Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease (CAD), which remains the leading cause of death in CKD patients. Despite the high cardiovascular risk, ACS patients with renal dysfunction are less commonly treated with guideline-based medical thera...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-10-01
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| Series: | Kidney Diseases |
| Subjects: | |
| Online Access: | https://beta.karger.com/Article/FullText/533970 |
| _version_ | 1797626806023487488 |
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| author | Ilya Losin Keren-Cohen Hagai David Pereg |
| author_facet | Ilya Losin Keren-Cohen Hagai David Pereg |
| author_sort | Ilya Losin |
| collection | DOAJ |
| description | Background: Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease (CAD), which remains the leading cause of death in CKD patients. Despite the high cardiovascular risk, ACS patients with renal dysfunction are less commonly treated with guideline-based medical therapy and are less frequently referred for coronary revascularization. Summary: The management of CAD is more challenging in patients with CKD than in the general population due to concerns regarding side effects and renal toxicity, as well as uncertainty regarding clinical benefit of guideline-based medical therapy and interventions. Patients with advanced CKD and especially those receiving dialysis have not traditionally been represented in randomized trials evaluating either medical or revascularization therapies. Thus, only scant data from small prospective studies or retrospective analyses are available. Recently published studies suggest that there are significant opportunities to substantially improve both cardiovascular and renal outcomes of patients with CAD and CKD, including new medications and interventions. Thus, the objective of this review is to summarize the current evidence regarding the management of CAD in CKD patients, in particular with respect to improvement of both cardiovascular and renal outcomes. Key Messages: Adequate medical therapy and coronary interventions using evidence-based strategies can improve both cardiac and renal outcomes in patients with CAD and CKD. |
| first_indexed | 2024-03-11T10:15:25Z |
| format | Article |
| id | doaj.art-18a68759872e40518fd2d373482c9cf6 |
| institution | Directory Open Access Journal |
| issn | 2296-9357 |
| language | English |
| last_indexed | 2024-03-11T10:15:25Z |
| publishDate | 2023-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney Diseases |
| spelling | doaj.art-18a68759872e40518fd2d373482c9cf62023-11-16T07:58:21ZengKarger PublishersKidney Diseases2296-93572023-10-0111110.1159/000533970533970The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and SolutionsIlya Losin0Keren-Cohen Hagai1David Pereg2Cardiology Department, Meir Medical Center, Kfar Saba, IsraelDepartment of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, IsraelCardiology Department, Meir Medical Center, Kfar Saba, IsraelBackground: Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease (CAD), which remains the leading cause of death in CKD patients. Despite the high cardiovascular risk, ACS patients with renal dysfunction are less commonly treated with guideline-based medical therapy and are less frequently referred for coronary revascularization. Summary: The management of CAD is more challenging in patients with CKD than in the general population due to concerns regarding side effects and renal toxicity, as well as uncertainty regarding clinical benefit of guideline-based medical therapy and interventions. Patients with advanced CKD and especially those receiving dialysis have not traditionally been represented in randomized trials evaluating either medical or revascularization therapies. Thus, only scant data from small prospective studies or retrospective analyses are available. Recently published studies suggest that there are significant opportunities to substantially improve both cardiovascular and renal outcomes of patients with CAD and CKD, including new medications and interventions. Thus, the objective of this review is to summarize the current evidence regarding the management of CAD in CKD patients, in particular with respect to improvement of both cardiovascular and renal outcomes. Key Messages: Adequate medical therapy and coronary interventions using evidence-based strategies can improve both cardiac and renal outcomes in patients with CAD and CKD.https://beta.karger.com/Article/FullText/533970chronic kidney diseasecoronary artery diseasecontrast-induced nephropathycoronary intervention |
| spellingShingle | Ilya Losin Keren-Cohen Hagai David Pereg The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions Kidney Diseases chronic kidney disease coronary artery disease contrast-induced nephropathy coronary intervention |
| title | The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions |
| title_full | The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions |
| title_fullStr | The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions |
| title_full_unstemmed | The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions |
| title_short | The Treatment of Coronary Artery Disease in Patients with Chronic Kidney Disease: Gaps, Challenges, and Solutions |
| title_sort | treatment of coronary artery disease in patients with chronic kidney disease gaps challenges and solutions |
| topic | chronic kidney disease coronary artery disease contrast-induced nephropathy coronary intervention |
| url | https://beta.karger.com/Article/FullText/533970 |
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