AHA24 Screening for Kidney Disease to Reduce CVD Risk: uACR and eGFR

6 Introduction Chronic kidney disease (CKD) is a common and potentially deadly condition that is universally underrecognized as it can progress silently and unpredictably. And while symptoms may not appear until the disease is well-advanced, impaired kidney function can increase the risk of cardiovascular disease (CVD) two- to fourfold.1 Impaired kidney function is an independent risk factor for developing multiple forms of CVD, including: • heart failure • atrial fibrillation • stroke • coronary heart disease • peripheral artery disease • sudden cardiac death1-Results The relationship between CVD and CKD is bidirectional, with each condition increasing the incidence and progression of the other. Early testing and diagnosis of CKD is critical to improving health outcomes, using early treatment to prevent progression of both CVD and CKD. Because early-stage CKD often has few overt symptoms and is seldom recognized, early screening for CKD in both children and adults with diabetes, hypertension and metabolic syndrome using eGFR and uACR is encouraged to reduce the risk of CVD.2-Top 10 Highlights The interplay between CVD and CKD is detailed in Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory from the American Heart Association.2 Both cardioprotective and kidney protective treatments are available and may be prescribed as appropriate.3-Novel Therapeutic Approaches, 4-Figure 3 CKM syndrome The link between CVD and CKD has been recognized since the 1830s.1-Results CVD and CKD are mutually reinforcing co-contributors to excess morbidity and mortality, an association now recognized as cardiovascular-kidney-metabolic (CKM) syndrome. This bidirectional association between heart and kidneys links disorder in either organ with disorder in the other.2-Introduction There is an exponential increase in absolute risk for all-cause and cardiovascular mortality with decreasing kidney function even after adjusting for other established risk factors.3-Epidemiology and prognosis CKD can be assessed using two common laboratory tests widely available in primary care and other settings: • estimated glomerular filtration rate (eGFR) • urinary albumin-to-creatinine ration (uACR).

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