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Chronic Kidney DiseaseCause and Consequence of Cardiovascular Disease
Barry I. Freedman, MD;
Thomas D. DuBose Jr, MD
Arch Intern Med. 2007;167(11):1113-1115.
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The widely held view that albuminuria and/or reduced glomerular filtration rate (GFR) inexorably progress to end-stage renal disease (ESRD) requiring kidney replacement therapy is not uniformly accurate. Inadequately treated nephropathy risk factors in those with chronic kidney disease (CKD) such as hyperglycemia, hypertension, and proteinuria often lead to declining kidney function. However, the number of individuals at risk for ESRD by virtue of having CKD demonstrates that only a minority reach ESRD.1 Indeed, most will ultimately die of cardiovascular disease (CVD) before needing renal replacement therapy.2
There are currently about 387 000 patients in the United States and 1.8 million worldwide who require dialysis therapy or kidney transplantation for survival.1, 3 Among the 100 000 patients with incident ESRD in the United States each year, 42% have diabetic nephropathy, more than 90% from type 2 diabetes mellitus.1 The US health care system has not . . . [Full Text of this Article]
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