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Therapy of chronic renal insufficiency – from renal physiology to cardiovascular outcomes

Rainer U Pliquett

Chronic renal insufficiency (CRI) and atherosclerosis are tightly connected clinical syndromes. Overall, renal function assessed by estimated glomerular filtration rate correlates with total and cardiovascular mortality in a graded fashion. In addition, microalbuminuria is a prognostic indicator for both progression of CRI and adverse cardiovascular outcomes. CRI-related neurohumoral stimulation including the renin-angiotensin-aldosterone system and the sympathetic nervous system is focused on, therapeutic implications are provided. Last, the role of systemic inflammation with respect to endothelial function, vascular calcification and metabolism is being highlighted. This review aims to summarize recent research results about CRI pathomechanisms relevant to cardiovascular disease.