CHRONIC KIDNEY DISEASE AND CARDIOVASCULAR RISK: AN INTEGRATED APPROACH

Abstract

Chronic Kidney Disease (CKD) is a high global burden condition, associated not only with progressive loss of kidney function but also with a significantly elevated risk of cardiovascular mortality. It is estimated that more than 700 million people live with some degree of CKD, with marked disparities in access to dialysis, transplantation, and integrated management. International guidelines, such as KDIGO 2012, have established the importance of estimated glomerular filtration rate and albuminuria as independent predictors of cardiovascular outcomes, evidence reinforced by collaborative meta-analyses that confirmed the relationship between declining kidney function, albuminuria, and early mortality. From a pathophysiological perspective, the interconnection between CKD and cardiovascular risk is mediated by mechanisms such as neurohormonal activation, chronic inflammation, oxidative stress, and vascular remodeling. In recent years, therapeutic advances have transformed the clinical landscape: SGLT2 inhibitors have reduced CKD progression and cardiovascular events even in patients without diabetes, while finerenone and GLP-1 agonists have expanded treatment options with a positive impact on renal and cardiac outcomes. At the same time, the importance of conservative management and supportive care as part of comprehensive care is growing, especially in advanced stages. It follows that CKD must be recognized as a central determinant of global cardiovascular risk, requiring early detection strategies, the incorporation of new therapies, and integrated care models that balance clinical efficacy, equity, and quality of life.