Cardio-renal interaction in coronary artery disease

Chronic kidney disease (CKD) is one of major risk factors for coronary artery disease. It increases the risk of acute coronary syndrome (ACS). Indeed, patients presenting with ACS are more likely to have CKD than those presenting with chronic coronary syndrome and this association is related to the severity of pre-existing CKD [ [1] Go A.S. Bansal N. Chandra M. Lathon P.V. Fortmann S.P. Iribarren C. Hsu C.Y. Hlatky M.A. ADVANCE Study Investigators Chronic kidney disease and risk for presenting with acute myocardial infarction versus stable exertional angina in adults with coronary heart disease. J. Am. Coll. Cardiol. 2011; 58: 1600-1607 Crossref PubMed Scopus (60) Google Scholar ]. Various mechanisms can be explained for the association. Reports suggest that a close association exists between the glomerular filtration rate (GFR), coronary plaque characteristics, and coronary atherosclerosis severity [ [2] Nakano T. Ninomiya T. Sumiyoshi S. Fujii H. Doi Y. Hirakata H. Tsuruya K. Iida M. Kiyohara Y. Sueishi K. Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: the Hisayama study. Am. J. Kidney Dis. 2009; 55: 21-30 Abstract Full Text Full Text PDF PubMed Scopus (159) Google Scholar ]. Since the estimated GFR (eGFR) can be easily calculated according to serum creatinine, age, and sex, it has been widely used in the clinical practice. (See Fig. 1.) Microalbuminuria during acute coronary syndrome: Association with 22-year mortality and causes of death. The ABC-8* study on heart disease. (*ABC is an acronym for Adria, Bassano, Conegliano, and Padova Hospitals)International Journal of CardiologyVol. 374PreviewMicroalbuminuria is associated with adverse outcomes in acute coronary syndrome (ACS) patients. Full-Text PDF Open Access