Insights into the Association of Chronic Kidney Disease (CKD) and Cardiovascular Risk Among Diabetic vs. Non-Diabetic Patients.

ABSTRACT

Diabetic patients with chronic kidney disease have a high risk of developing cardiovascular disease-related mortality and morbidity compared to non-diabetic chronic kidney disease patients. Majority of chronic kidney disease patients with diabetes remain undiagnosed for and have a higher incidence of cardiovascular comorbidities even when they do not progress to end-stage renal failure. Both traditional cardiovascular risk factors and nontraditional cardiovascular risk factors are known to be present in higher magnitude in diabetic patients with chronic kidney disease and are known to partially account for the increased incidence of cardiovascular disease compared to non-diabetic chronic kidney disease patients. Moreover, there is no definitive evidence for potential therapeutic treatment options for cardiovascular disease among diabetic patients with chronic kidney disease as these patients have been often not included in major cardiovascular trials. Therefore, there is a need for recognizing diabetic patients with chronic kidney disease patients having high cardiovascular disease risk for definite and immediate medical attention at an individual patient level. Increased awareness, timely diagnosis, and intervention with respect to the control of these plays a pivotal role in avoiding undesirable cardiovascular disease events and leads to improved treatment outcomes among these patients. Further research is warranted to understand the risk factors for cardiovascular disease and to develop and implement preventive and treatment strategies to decrease the high morbidity and mortality among diabetic patients with chronic kidney disease. This review summarizes the available epidemiological data, risk factors, discusses clinical presentations, and suggests prevention and management strategies of cardiovascular disease risk among diabetic patients with chronic kidney disease.