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2018 ; 10
(6
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Deleting Death and Dialysis: Conservative Care of Cardio-Vascular Risk and Kidney
Function Loss in Chronic Kidney Disease (CKD)
#MMPMID29895722
Vanholder R
; Van Laecke S
; Glorieux G
; Verbeke F
; Castillo-Rodriguez E
; Ortiz A
Toxins (Basel)
2018[Jun]; 10
(6
): ä PMID29895722
show ga
The uremic syndrome, which is the clinical expression of chronic kidney disease
(CKD), is a complex amalgam of accelerated aging and organ dysfunctions, whereby
cardio-vascular disease plays a capital role. In this narrative review, we offer
a summary of the current conservative (medical) treatment options for
cardio-vascular and overall morbidity and mortality risk in CKD. Since the
progression of CKD is also associated with a higher cardio-vascular risk, we
summarize the interventions that may prevent the progression of CKD as well. We
pay attention to established therapies, as well as to novel promising options.
Approaches that have been considered are not limited to pharmacological
approaches but take into account lifestyle measures and diet as well. We took as
many randomized controlled hard endpoint outcome trials as possible into account,
although observational studies and post hoc analyses were included where
appropriate. We also considered health economic aspects. Based on this
information, we constructed comprehensive tables summarizing the available
therapeutic options and the number and kind of studies (controlled or not,
contradictory outcomes or not) with regard to each approach. Our review
underscores the scarcity of well-designed large controlled trials in CKD.
Nevertheless, based on the controlled and observational data, a therapeutic
algorithm can be developed for this complex and multifactorial condition. It is
likely that interventions should be aimed at targeting several modifiable factors
simultaneously.