Abstract

INSERRA, Felipe  and  BELLO, Carlos Castellaro. Systemic Vasculature In Chronic Kidney Disease. First Part. Rev. nefrol. dial. traspl. [online]. 2019, vol.39, n.4, pp.279-290. ISSN 2346-8548.

The heart-kidney relation generates special interest among the medical population given that this interaction has a strong impact on health and is wide and complex. Chronic kidney disease causes changes in the vascular structure and function with a major hemodynamic repercussion. Arterial hardening resulting from vascular inflammation produces changes in the ventricular-arterial coupling and, as a consequence, the alteration of tissue perfusion and left ventricle function. Chronic renal failure activates an inflammatory cascade which generates endothelium alteration and increases the tone/thickness of the artery medial layer.

At the same time, the autonomic imbalance and the accumulation of pro-inflammatory and profibrotic mediators also contribute to the alteration of vascular structure and function. Among the changes in the mechanical properties of the artery system, a fundamental mechanism of tissue perfusion is found, particularly, in low-resistance beds such as the brain and kidney, responsible for cognitive deterioration and kidney damage progression. Increased left ventricular afterload causes higher ventricular work leading to hypertrophy and failure.

The aim of this article is to make a revision of the processes described, integrate them into a physiopathological logic and give a clear idea of the impact of CKD upon cardiovascular damage.

Keywords : cardiorenal syndrome; chronic kidney disease; cardiovascular function; renal function; arteries.

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