How Does CKD Influence Adverse Outcomes?
There are a number of possible explanations for the observed association of CKD with adverse health outcomes. First, CKD shares many of the same risk factors as other vascular diseases, such as older age, hypertension, and diabetes, so CKD may be a marker for undiagnosed vascular disease or for a worsened prognosis among individuals with known vascular disease. Second, CKD may be associated with a number of nontraditional risk factors for vascular disease and mortality such as increased inflammation or bone mineral disorders. Third, CKD may be a marker for individuals less likely to receive proven medical therapies. For example, among individuals with a myocardial infarction, those with CKD are less likely to receive proven effective therapies such as coronary artery bypass, ace-inhibitors (ACEI), beta-blockers, or HMG CoA-reductase inhibitors (i.e., statins) medications.17 Therefore, systematic undertreatment may in part underlie the association between CKD and adverse health outcomes