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Beyond (or Back to) Traditional Risk Factors: Preventing Cardiovascular Disease in Patients with Chronic Kidney Disease

Lawrence J. Appel, MD, MPH
[+] Article and Author Information

From Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21205.


Acknowledgments: The author thanks Thomas Erlinger, Jeff Fink, Eliseo Guallar, Edgar Miller, and Jean Marie Ricketts for their insightful comments on draft versions of this editorial.

Grant Support: Research grants DK61022 and DK45430 from the National Institute of Diabetes, Digestive and Kidney Diseases.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Lawrence J. Appel, MD, MPH, Johns Hopkins University, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21205-2223; e-mail, lappel@jhmi.edu.


Ann Intern Med. 2004;140(1):60-61. doi:10.7326/0003-4819-140-1-200401060-00013
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Patients with chronic kidney disease carry an extraordinarily high risk for cardiovascular disease (CVD). In fact, most patients with chronic kidney disease will die of CVD before reaching end-stage kidney disease (1). A logical starting point for CVD prevention efforts in this population is determining the extent to which traditional CVD risk factors (that is, smoking, blood pressure, diabetes, and hypercholesterolemia) are responsible for the excess risk for CVD. In this issue, Muntner and colleagues (2) highlight the possibility that other risk factors, commonly termed nontraditional risk factors, also contribute to the burden of CVD in this population.

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