Chronic Renal Failure and Cardiovascular Disease—from Molecular Aspects to Clinical Practice

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 26 July 2024 | Viewed by 3594

Special Issue Editors


E-Mail Website
Guest Editor
Departement of Medicine and Surgery, University of Salerno, 84081 Baronissi, Italy
Interests: vascular dysfunction; oxidative stress; hypertension; atherosclerosis; experimental models; cardiovascular diseases; diabetes
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
Interests: cardiovascular disease; internal medicine; basic science; translational medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic renal failure (CRF) and cardiovascular disease (CVD) are intricately linked, with a complex interplay of molecular mechanisms contributing to their association. Understanding these connections is crucial for both preventing and managing these conditions in clinical practice.

At the molecular level, several factors contribute to the heightened risk of cardiovascular disease in individuals with chronic renal failure. One key player is endothelial dysfunction, where the inner lining of blood vessels fails to function optimally. In CRF, there is a dysregulation of endothelial nitric oxide synthase (eNOS), leading to reduced nitric oxide production, a vasodilator that helps maintain blood vessel health. This dysfunction promotes atherosclerosis, i.e., the buildup of plaques in arterial walls, which is a hallmark of cardiovascular disease.

Another molecular aspect involves the renin–angiotensin–aldosterone system (RAAS), a hormonal system that regulates blood pressure and fluid balance. In chronic renal failure, there is an overactivation of the RAAS, contributing to hypertension and fostering cardiovascular complications. The excessive release of aldosterone, a hormone that regulates sodium and potassium balance, further promotes inflammation, oxidative stress, and fibrosis, all of which contribute to cardiovascular pathology.

Furthermore, chronic inflammation is a common denominator in both chronic renal failure and cardiovascular disease. In CRF, the persistent inflammation is driven by factors such as uremic toxins and the activation of immune cells. This chronic inflammatory state extends its detrimental effects to the cardiovascular system, promoting atherosclerosis and increasing the risk of adverse cardiovascular events.

Moving from molecular mechanisms to clinical practice, the intersection of chronic renal failure and cardiovascular disease necessitates a comprehensive approach to patient care. The early detection and management of risk factors play a pivotal role. Furthermore, the regular monitoring of blood pressure, lipid levels, and renal function is essential for identifying individuals at risk. Lifestyle modifications, including a heart-healthy diet, regular exercise, and smoking cessation, are crucial in preventing the progression of both conditions.

Pharmacological interventions targeting specific molecular pathways are also integral components of clinical management. Medications that inhibit the RAAS, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), have shown efficacy in reducing cardiovascular events in individuals with chronic renal failure. Additionally, statins, which lower cholesterol levels, and antiplatelet agents may be prescribed to mitigate the risk of atherosclerotic events.

The management of chronic renal failure and cardiovascular disease is a collaborative effort between nephrologists and cardiologists. A multidisciplinary approach ensures that interventions are tailored to address the unique challenges posed by the coexistence of these conditions. Renal replacement therapies, including dialysis or kidney transplantation, may be considered in the advanced cases of chronic renal failure, with close attention to cardiovascular considerations in the selection of appropriate interventions.

In conclusion, the intricate relationship between chronic renal failure and cardiovascular disease extends from molecular intricacies to clinical implications. Understanding the molecular aspects provides insights into the shared pathways that drive these conditions, enabling clinicians to adopt a targeted and holistic approach to patient care. From the early detection to the implementation of lifestyle modifications and pharmacological interventions, the management of CRF and CVD requires a comprehensive strategy to improve patient outcomes and enhance their overall quality of life.

On this basis, we invite investigators to contribute original research as well as review articles.

Potential topics include but are not limited to the following:

- The identification of novel molecules and mechanisms involved in the onset and progression of chronic renal failure and cardiovascular diseases;
- Novel potential therapeutic approaches to reduce the onset of chronic renal failure and cardiovascular diseases;
- The identification of novel management strategies to prevent chronic renal failure and cardiovascular diseases;
- The discovery of novel clinical and pharmacological approaches to slow down chronic renal failure and cardiovascular disease progression.

Dr. Albino Carrizzo
Dr. Paola Di Pietro
Dr. Carmine Izzo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular disease (CVD)
  • chronic kidney disease (CKD)
  • ESKD
  • heart
  • vascular calcification

Published Papers (3 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

15 pages, 1229 KiB  
Article
Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients
by Maria Kislikova, Jorge Javier Gaitán-Valdizán, José Antonio Parra Blanco, María Teresa García Unzueta, María Rodríguez Vidriales, Clara Escagedo Cagigas, Vicente Celestino Piñera Haces, María de la Oliva Valentín Muñoz, Adalberto Benito Hernández, Juan Carlos Ruiz San Millan and Emilio Rodrigo Calabia
Life 2024, 14(4), 533; https://doi.org/10.3390/life14040533 - 22 Apr 2024
Viewed by 784
Abstract
In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart [...] Read more.
In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 ± 30 mL/min/1.73 m2. Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = −0.362, p < 0.001) and total coronary calcification (r = −0.194, p = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (β = −0.189; −0.739–−0.027; p = 0.035) and high-sensitivity troponin I (β = −0.301; −0.259–−0.071; p < 0.001). Severe coronary calcification (Agatston score ≥ 400 HU) was related to a worse eGFR (p = 0.008), a higher grade of CKD (p = 0.036), and a thinner pRNFL (p = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of ≥400 HU (AUC 0.638; 95% CI 0.525–0.750; p = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population. Full article
Show Figures

Figure 1

Review

Jump to: Research

21 pages, 1507 KiB  
Review
Vitamin D: A Bridge between Kidney and Heart
by Carmine Secondulfo, Valeria Visco, Nicola Virtuoso, Martino Fortunato, Serena Migliarino, Antonella Rispoli, Lucia La Mura, Adolfo Stellato, Giuseppe Caliendo, Emanuela Settembre, Fabiana Galluccio, Sarah Hamzeh and Giancarlo Bilancio
Life 2024, 14(5), 617; https://doi.org/10.3390/life14050617 - 10 May 2024
Viewed by 674
Abstract
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are highly prevalent conditions, each significantly contributing to the global burden of morbidity and mortality. CVD and CKD share a great number of common risk factors, such as hypertension, diabetes, obesity, and smoking, among others. [...] Read more.
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are highly prevalent conditions, each significantly contributing to the global burden of morbidity and mortality. CVD and CKD share a great number of common risk factors, such as hypertension, diabetes, obesity, and smoking, among others. Their relationship extends beyond these factors, encompassing intricate interplay between the two systems. Within this complex network of pathophysiological processes, vitamin D has emerged as a potential linchpin, exerting influence over diverse physiological pathways implicated in both CKD and CVD. In recent years, scientific exploration has unveiled a close connection between these two prevalent conditions and vitamin D, a crucial hormone traditionally recognized for its role in bone health. This article aims to provide an extensive review of vitamin D’s multifaceted and expanding actions concerning its involvement in CKD and CVD. Full article
Show Figures

Figure 1

19 pages, 702 KiB  
Review
Chronic Kidney Disease with Mineral Bone Disorder and Vascular Calcification: An Overview
by Carmine Izzo, Carmine Secondulfo, Giancarlo Bilancio, Valeria Visco, Nicola Virtuoso, Serena Migliarino, Michele Ciccarelli, Paola Di Pietro, Lucia La Mura, Antonio Damato, Albino Carrizzo and Carmine Vecchione
Life 2024, 14(3), 418; https://doi.org/10.3390/life14030418 - 21 Mar 2024
Cited by 2 | Viewed by 1890
Abstract
Chronic kidney disease (CKD) is a global health issue with a rising prevalence, affecting 697.5 million people worldwide. It imposes a substantial burden, contributing to 35.8 million disability-adjusted life years (DALYs) and 1.2 million deaths in 2017. The mortality rate for CKD has [...] Read more.
Chronic kidney disease (CKD) is a global health issue with a rising prevalence, affecting 697.5 million people worldwide. It imposes a substantial burden, contributing to 35.8 million disability-adjusted life years (DALYs) and 1.2 million deaths in 2017. The mortality rate for CKD has increased by 41.5% between 1990 and 2017, positioning it as a significant cause of global mortality. CKD is associated with diverse health complications, impacting cardiovascular, neurological, nutritional, and endocrine aspects. One prominent complication is CKD–mineral and bone disorder (MBD), a complex condition involving dysregulation of bone turnover, mineralization, and strength, accompanied by soft tissue and vascular calcification. Alterations in mineral metabolism, including calcium, phosphate, parathyroid hormone (PTH), vitamin D, fibroblast growth factor-23 (FGF-23), and Klotho, play pivotal roles in CKD-MBD. These disturbances, observed early in CKD, contribute to the progression of bone disorders and renal osteodystrophy (ROD). Vascular calcification (VC) is a key component of CKD-MBD, accelerated by CKD. The pathophysiology involves complex processes in vascular smooth muscle cells and the formation of calciprotein particles (CPP). VC is closely linked to cardiovascular events and mortality, emphasizing its prognostic significance. Various serum markers and imaging techniques, including lateral plain X-ray, Kauppila Score, Adragao Score, and pulse wave velocity, aid in VC detection. Additionally, pQCT provides valuable information on arterial calcifications, offering an advantage over traditional scoring systems. CKD poses a substantial global health burden, and its complications, including CKD-MBD and VC, significantly contribute to morbidity and mortality. Understanding the intricate relationships between mineral metabolism, bone disorders, and vascular calcification is crucial for effective diagnosis and therapeutic interventions. Full article
Show Figures

Figure 1

Back to TopTop