CARDIOVASCULAR MANIFESTATIONS OF CHRONIC RENAL FAILURE

Abstract

Chronic renal failure (CRF) is a prevalent clinical condition, associated with a series of systemic manifestations that go beyond renal impairment. Among these, cardiovascular manifestations play a significant role, contributing to patient morbidity and mortality. The interconnection between compromised renal function and cardiovascular complications is complex and multifactorial, involving hemodynamic changes, metabolic dysfunctions and activation of inflammatory pathways. Understanding the extent and mechanisms behind cardiovascular manifestations in CKD is essential for effective clinical management of these patients. Objective: To analyze and synthesize the available evidence on cardiovascular manifestations associated with chronic renal failure. We seek to understand the nature, prevalence and mechanisms underlying these manifestations in order to offer valuable insights for clinical practice and identify gaps in knowledge that can guide future research.Methodology: The review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We used the PubMed, Scielo and Web of Science databases to identify relevant articles published in the last 10 years. The descriptors used were "chronic renal failure", "cardiovascular manifestations", "cardiovascular kidney disease", "cardiovascular function in CKD" and "cardiovascular mechanisms in CKD". Three inclusion criteria were applied: studies published between 2013 and 2023, focusing on cardiovascular manifestations of CRF and articles in English, Portuguese or Spanish. Three exclusion criteria were adopted: studies with pediatric samples, non-systematic reviews and studies not related to the main topic. Results: Analysis of the selected articles revealed a variety of cardiovascular manifestations associated with chronic renal failure, including arterial hypertension, dyslipidemia, cardiac remodeling , accelerated atherosclerosis and increased risk of adverse cardiovascular events. Pathophysiological mechanisms, such as activation of the renin-angiotensin-aldosterone system and chronic inflammation, have been consistently identified. Therapeutic interventions to mitigate these manifestations have also been addressed in the literature. Conclusion: This review highlights the complexity of cardiovascular manifestations in chronic renal failure and highlights the importance of a multidisciplinary approach in the management of these patients. In-depth understanding of the underlying pathophysiological mechanisms and identification of effective therapeutic strategies are crucial to improving cardiovascular outcomes in individuals with CKD. Furthermore, it highlights the need for future investigations to fill specific gaps in understanding these complex interactions between renal function and the cardiovascular system.