Cardiorenal Syndrome Mechanisms, Risk and Treatment
Accelerated cardiovascular disease is a frequent complication of chronic kidney disease. Individuals with evidence of renal functional impairment are more likely to die of cardiovascular events than to progress to end stage renal disease. This relationshi
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Adel E. Berbari • Giuseppe Mancia (Eds.)
Cardiorenal Syndrome Mechanisms, Risk and Treatment
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Editors Adel E. Berbari Department of Internal Medicine American University of Beirut Medical Center Beirut, Lebanon Giuseppe Mancia Clinica Medica Department of Clinical Medicine and Prevention University of Milano-Bicocca San Gerardo Hospital Monza, Milan, Italy
ISBN 978-88-470-1462-6
e-ISBN 978-88-470-1463-3
DOI 10.1007/978-88-470-1463-3 Springer Milan Dordrecht Heidelberg London New York Library of Congress Control Number: 2010925384 © Springer-Verlag Italia 2010 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the Italian Copyright Law in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the Italian Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. 9 8 7 6 5 4 3 2 1 Cover design: Simona Colombo, Milan, Italy Typesetting: Graphostudio, Milan, Italy Printing and binding: Arti Grafiche Nidasio, Assago (MI), Italy Printed in Italy Springer-Verlag Italia S.r.l. – Via Decembrio 28 – I-20137 Milan Springer is a part of Springer Science+Business Media (www.springer.com)
Preface
It has long been known that a close relationship exists between chronic kidney disease (CKD) and cardiovascular disease (CVD), which has led to the adoption of the terminology “cardiorenal syndrome”. In recent years, the relationship between CKD and CVD has been shown to be even closer because of the demonstration that renal function acts as a sensor of global (or total) CVD risk. It is thus now well documented that from the initial to the advanced stages of renal disease, the cardiovascular system is involved. Primary disorders of CKD are associated with an enhanced progression of CVD, even when renal function is only mildly impaired. A significant number of patients with CKD die of CVD complications before they progress to end-stage renal failure. This excessive CVD risk is attributed to a high burden of both conventional and kidney (uremia)-related factors as well as to a wide spectrum of clinicopathologic entities. Conversely, primary CV disorders can initiate and perpetuate functional renal impairment and progressive CKD. Overall, the presence of renal dysfunction is an o
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