Cardiovascular diseases in patients with renal disease: Epidemiology, pathophysiology and therapy [Kardiovaskuläre Erkrankungen bei Patienten mit Nierenerkrankungen: Epidemiologie, Pathophysiologie und Therapie]

Myocardial infarction, sudden cardiac death, chronic heart failure, and cerebrovascular insult are the most frequent diseases in western countries. The classical risk factors underlying these cardiovascular diseases are very well known: Diabetes mellitus, arterial hypertension, hyperlipoproteinemia, nicotin abuse and adipositas/ obesity as well as physical inactivity. During the last decade scientists have especially focussed on the association between diabetes (especially metabolic syndrome) and coronary artery disease. However, all of these coronary risk factors also have an influence on renal function: For example, endstage renal disease is the result from diabetes mellitus in 33% and from arterial hypertension in 22% of patients. On the other hand, the degree of renal function disturbance correlates well with the occurrence of cardiovascular events. Therefore, from a statistical point of view, renal insufficiency is not only an indicator or barometer for the cardiovascular risk factors, but rather a risk factor sui generis, i. e., it defines prognosis of patients. In this context, it is of special interest that patients with renal failure are not adaequately treated compared to other patients - regarding invasive as well as noninvasive medical strategies. © 2007 Springer Medizin Verlag.