Altération modérée de la fonction rénale et risque cardiovasculaire

The objective of this review is to analyze the relationship between moderate decrease in renal function and cardiovascular (CV) risk and to discuss the potential mechanisms of this association. Prevalence of chronic kidney disease (CKD) is increasing in developed countries. Several studies have shown that a moderate fall in glomerular filtration (GFR) or the presence of microalbuminuria is associated with an increase in CV risk, independently of the traditional CV risk factors. Mechanisms are probably multiple and could include anemia, calcium/phosphate metabolism, inflammation, but also large arteries function. In order to achieve primary or secondary prevention of CV risk, DFG should be estimated from serum creatinine and microalbuminuria should be assessed in every high risk subject. The finding of CKD implies optimal management of all traditional CV risk factors. Future studies are needed in order to evaluate the efficacy and safety of specific therapeutic approach to reduce CV risk in CKD.