Increased cardiovascular risk in patients with chronic kidney disease
CVD presentation in CKD
Traditional risk factors and prevention of CVD in CKD
Risk factors of CKD progression | Established therapeutic approaches targeting traditional cardiovascular risk factors in CKD |
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Blood pressure | Target values <130/80 mm Hg (KDIGO); 130–139 mm Hg syst., 120–129 mm Hg syst. (ESH) If necessary, <120 mm Hg systolic depending on comorbidities and underlying kidney disease RAAS inhibition (maximum tolerated dose) + diuretic and/or calcium channel blocker No combination of angiotensin II receptor blocker and ACE inhibitor in the case of poor risk–benefit profile |
Blood sugar | HbA1c target ~ 7.0–8.0% HbA1c target <6.5% in young patients without major comorbidities Metformin and SGLT2-inhibition at first-line therapy after lifestyle modification |
Dyslipidemia | HMG-CoA inhibitors (statins) Ezetimibe PCSK-9 inhibitors (eGFR >20 ml/min/1.73 m2) LDL cholesterol target values: – Patients with manifest atherosclerotic cardiovascular disease and very high-risk patients: LDL‑C <55 mg/dL and ≥50% reduction from baseline – High cardiovascular risk: LDL‑C <70 mg/dL and ≥50% reduction from baseline – Moderate/low cardiovascular risk: LDL‑C <116 mg/dL |