Document Type : Original Article

Authors

Department of Pharmacy Practice, Smt. Sarojini Ramulamma College of Pharmacy, Palamuru University, Sheshadri Nagar, Mahabubnagar District, Telangana, India

Abstract

Chronic kidney disease (CKD) is on the rise around the world and is strongly linked with the incidence of cardiovascular disease (CVD). This six-month observational study was conducted in the nephrology division of a 300-bed, multi-specialty tertiary care teaching hospital. A total of 90 prescriptions written for inpatients and outpatients in the nephrology ward are considered based on the inclusion criteria. Patient case sheets, patient questionnaires and interviews, biomedical and radiological reports, and the medication regimen chart are the primary means of data gathering. In this study, we identified the patient's age, hypertension, lipid abnormalities, male gender, cigarette smoking, and family history as traditional risk factors for both CVD and CKD. Nearly 40% of 90 individuals had a high risk of CVD, followed by 25 with intermediate risk, 19 with borderline risk, and 6 with low risk. We further conclude that successful CKD and CVD therapy requires good glycemic control, anti-hypertensive medicine, and hypolipidemic medication. Diabetes patients received SGLT-2 inhibitors, which improve CKD and CVD. The development of chronic kidney disease to stages 4 and 5 is slowed by anti-hypertensive medication, particularly with renin-angiotensin-aldosterone system inhibitors such as angiotensin-receptor blockers and angiotensin-converting enzyme (ACE) inhibitors. Patients with persistent hypertension, albuminuria, or heart failure with a poor ejection fraction benefit from treatment with aldosterone receptor antagonists. People with chronic kidney disease benefit from low-dose aspirin for secondary prevention of cardiovascular disease. Despite medication advancements, high blood pressure (BP) patients need a customised and evidence-based management plan to control BP, minimise CVD risk, and delay CKD progression. Early CKD treatment is essential for preventing the progression of both CKD and CVD.

Graphical Abstract

A study to assess the associated risk of developing cardiovascular diseases in chronic kidney disease

Keywords

Main Subjects

Selected author of this article by journal

Dr. Bujagouni Swapna
Palamuru University

ORCID

Open Access

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  1. Al-Zaidi HMH, Mousavinasab F, Radseresht N, Mirzaei AR, Moradi Y, Mahmoudifar M (2023) Investigation of GJB2 and SLC26A4 genes related to pendred syndrome genetic deafness patients. Cell Mol Biomed Rep 3 (3): 163-171. doi: https://doi.org/10.55705/cmbr.2023.379262.1093
  2. Aziziaram Z, Bilal I, Zhong Y, Mahmod AK, Roshandel MR (2021) Protective effects of curcumin against naproxen-induced mitochondrial dysfunction in rat kidney tissue. Cell Mol Biomed Rep 1 (1): 23-32. doi: Https://doi.org/10.55705/cmbr.2021.138879.1001
  3. Eknoyan G (2007) Chronic kidney disease definition and classification: the quest for refinements. Kidney International 72 (10): 1183-1185. doi: https://doi.org/10.1038/sj.ki.5002576
  4. Chen TK, Knicely DH, Grams ME (2019) Chronic kidney disease diagnosis and management: a review. Jama 322 (13): 1294-1304. doi: https://doi.org/10.1001/jama.2019.14745
  5. Lameire NH, Levin A, Kellum JA, Cheung M, Jadoul M, Winkelmayer WC, Stevens PE, Caskey FJ, Farmer CKT, Ferreiro Fuentes A, Fukagawa M, Goldstein SL, Igiraneza G, Kribben A, Lerma EV, Levey AS, Liu KD, MaƂyszko J, Ostermann M, Pannu N, Ronco C, Sawhney S, Shaw AD, Srisawat N (2021) Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney International 100 (3): 516-526. doi: https://doi.org/10.1016/j.kint.2021.06.028
  6. Hobson S, Arefin S, Witasp A, Hernandez L, Kublickiene K, Shiels P, Stenvinkel P (2023) Accelerated vascular aging in chronic kidney disease: the potential for novel therapies. Circulation Research 132 (8): 950-969. doi: https://doi.org/10.1161/CIRCRESAHA.122.321751
  7. Briasoulis A, Bakris GL (2013) Chronic kidney disease as a coronary artery disease risk equivalent. Current cardiology reports 15: 1-6. doi: https://doi.org/10.1007/s11886-012-0340-4
  8. Ahani H, Attaran S (2022) Therapeutic potential of Seabuckthorn (Hippophae rhamnoides L.) in medical sciences. Cell Mol Biomed Rep 2 (1): 22-32. doi: https://doi.org/10.55705/cmbr.2022.330326.1020
  9. Alavi H, Zaheri F, Shahoei R (2023) Support and control during childbirth and attachment after birth in mothers referring to comprehensive health centers in Bijar, 2019. Cell Mol Biomed Rep 3 (1): 17-28. doi: Https://doi.org/10.55705/cmbr.2022.355559.1055
  10. Agarwal R, Anker SD, Bakris G, Filippatos G, Pitt B, Rossing P, Ruilope L, Gebel M, Kolkhof P, Nowack C (2022) Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: the role of finerenone. Nephrology Dialysis Transplantation 37 (6): 1014-1023. doi: https://doi.org/10.1093/ndt/gfaa294
  11. Fox CS, Matsushita K, Woodward M, Bilo HJ, Chalmers J, Heerspink HJL, Lee BJ, Perkins RM, Rossing P, Sairenchi T (2012) Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. The Lancet 380 (9854): 1662-1673. doi: https://doi.org/10.1016/s0140-6736(12)61350-6
  12. Doosti-Moghaddam M, Miri HR, Ghahghaei A, Hajinezhad MR, Saboori H (2022) Effect of unripe fruit extract of Momordica charantia on total cholesterol, total triglyceride and blood lipoproteins in the blood of rats with hyperlipidemia. Cell Mol Biomed Rep 2 (2): 74-86. doi: https://doi.org/10.55705/cmbr.2022.338806.1038
  13. Ercisli MF, Lechun G, Azeez SH, Hamasalih RM, Song S, Aziziaram Z (2021) Relevance of genetic polymorphisms of the human cytochrome P450 3A4 in rivaroxaban-treated patients. Cell Mol Biomed Rep 1 (1): 33-41. doi: Https://doi.org/10.55705/cmbr.2021.138880.1003
  14. Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Rossing P, Kolkhof P, Nowack C, Schloemer P, Joseph A (2020) Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. New England Journal of Medicine 383 (23): 2219-2229. doi: https://doi.org/10.1056/NEJMoa2025845
  15. Rahbar-Karbasdehi E, Rahbar-Karbasdehi F (2021) Clinical challenges of stress cardiomyopathy during coronavirus 2019 epidemic. Cell Mol Biomed Rep 1 (2): 88-90. doi: https://doi.org/10.55705/cmbr.2021.145790.1018
  16. Reddy PR, Poojitha G, Kavitha S, Samreen SL, Naseer A, Koteswari P, Soumya P (2022) A prospective observational study to assess the cardiac risk factors and treatment patterns in established heart diseases. Cell Mol Biomed Rep 2 (4): 265-275. doi: Https://doi.org/10.55705/cmbr.2022.362447.1067
  17. Sumanth N, Soumya P, Tabassum A, Mamatha P, Yamini G, Meghamala K, Pravalika G (2023) A study to assess the co-morbidities and complications of polycystic ovarian syndrome. Cell Mol Biomed Rep 3 (2): 107-113. doi: Https://doi.org/10.55705/cmbr.2023.374547.1086
  18. Paisley KE, Beaman M, Tooke JE, Mohamed-Ali V, Lowe GDO, Shore AC (2003) Endothelial dysfunction and inflammation in asymptomatic proteinuria. Kidney International 63 (2): 624-633. doi: https://doi.org/10.1046/j.1523-1755.2003.00768.x
  19. Subbiah AK, Chhabra YK, Mahajan S (2016) Cardiovascular disease in patients with chronic kidney disease: a neglected subgroup. Heart Asia 8 (2): 56. doi: https://doi.org/10.1136%2Fheartasia-2016-010809
  20. Stevens PE, Levin A, Members* KDIGOCKDGDWG (2013) Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Annals of internal medicine 158 (11): 825-830. doi: https://doi.org/10.7326/0003-4819-158-11-201306040-00007
  21. Raghavan V, Anandh U (2023) Journey of a Patient with CKD in India. Kidney360 4 (5): 684-686. doi: https://doi.org/10.34067/KID.0000000000000124
  22. Levin A, Bilous R, Coresh J (2013) Chapter 1: Definition and classification of CKD. Kidney Int Suppl 3 (1): 19-62. doi: https://doi.org/10.1038%2Fkisup.2012.64
  23. John O, Gummudi B, Jha A, Gopalakrishnan N, Kalra OP, Kaur P, Kher V, Kumar V, Machiraju RS, Osborne N, Palo SK, Parameswaran S, Pati S, Prasad N, Rathore V, Rajapurkar MM, Sahay M, Tatapudi RR, Thakur JS, Venugopal V, Jha V (2021) Chronic Kidney Disease of Unknown Etiology in India: What Do We Know and Where We Need to Go. Kidney International Reports 6 (11): 2743-2751. doi: https://doi.org/10.1016/j.ekir.2021.07.031
  24. Kovesdy CP (2022) Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements 12 (1): 7-11. doi: https://doi.org/10.1016/j.kisu.2021.11.003
  25. Wanner C, Inzucchi SE, Lachin JM, Fitchett D, von Eynatten M, Mattheus M, Johansen OE, Woerle HJ, Broedl UC, Zinman B (2016) Empagliflozin and progression of kidney disease in type 2 diabetes. New England Journal of Medicine 375 (4): 323-334. doi: https://doi.org/10.1056/nejmoa1515920
  26. FernándezBalsells MM, Sojo-Vega L, Ricart-Engel W (2017) Canagliflozin and cardiovascular and renal events in type 2 diabetes. The New England journal of medicine 377 (21): 2098. doi: https://doi.org/10.1056/nejmc1712572
  27. American-Diabetes-Association (2018) American Diabetes Association. (2018) Standards of Medical Care in Diabetes-2018 Abridged for Primary Care Providers. 36 (1): 14-37. doi: https://doi.org/10.2337%2Fcd17-0119
  28. McCullough PA, Nowak RM, Foreback C, Tokarski G, Tomlanovich MC, Khoury N, Weaver WD, Sandberg KR, McCord J (2002) Emergency evaluation of chest pain in patients with advanced kidney disease. Archives of internal medicine 162 (21): 2464-2468. doi: https://doi.org/10.1001/archinte.162.21.2464
  29. Shlipak MG, Heidenreich PA, Noguchi H, Chertow GM, Browner WS, McClellan MB (2002) Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Annals of internal medicine 137 (7): 555-562. doi: https://doi.org/10.7326/0003-4819-137-7-200210010-00006