Table 1.

Less traditional cardiovascular (CV) risk factors more frequent in chronic kidney disease (CKD)

Hyperactivation of RAAS

Sympathetic over-reactivity

Insufficient pressure-natriuresis (with consequent volume overload, arterial hypertension, venous congestion and heart failure)

CKD-related mineral and bone disorders( CKD-MBD): ↑ P, ↑ FGF23,↓ Kloto, ↑ PTH, ↑ propensity for vascular calcifications, Vitamin D deficiency

Endothelial dysfunction and nitric oxide inhibition

Atherosclerosis, intima media thickness, arterial stiffness

Inflammation (↑ CRP,↑ TNF-α, ↑ fibrinogen, ↑ Cytokines) and malnutrition

Accumulation of uremic toxins (ADMA, p-cresyl sulfate, indoxyl-sulfate, indole-3 acetic acid, trimethylamine N-oxide, etc.)

Hyperhomocysteinemia

Anemia (↓ EPO, iron depletion)

↑ Uric acid levels

Low or extremely high bicarbonate levels

Uremic dyslipidemia

ADMA asymetric dimethylarginine, CRP C-reactive protein, FGF23 fibroblast growth factor 23, EPO erythropoietin, PTH parathyroid hormone, RAAS renin–angiotensin–aldosterone system, TNF-α tumor necrosis factor-α