Cardiovascular disease is the main cause of death in adults with renal failure and this fact should be borne in mind when managing children with CRF as many of the risk factors which contribute to this problem will be present from the onset of the CRF.
Risk factors for cardiovascular disease
| Classical risk factors for atherosclerosis found in renal disease: | |
| Dyslipidaemia: hypercholesterolaemia, decreased HDL, hypertriglyceridaemia, increased VLDL |
|
| Hyperinsulinaemia | Smoking |
| Hypercoagulability | Sedentary lifestyle |
| Hypertension | Obesity |
| Other causes specific to uraemia: | |
| Hyperparathyroidism | |
| Phosphate retention | |
| Iatrogenic iron overload | |
| Inadequate dialysis | |
| Hyperhomocystinaemia (folate deficiency, pyridoxine deficiency) | |
| Endothelial dysfunction | |
| Carbamylation of matrix proteins | |
| Carbamylation of lipoproteins | |
| Decreased anti-oxidant activity | |
| Hyperoxalaemia | |