Genetic Determinants of Increased Burdens of Cardiovascular Disease inPatients with Chronic Kidney Disease: A Narrative Review of theLiterature

Abstract

Cardiovascular disease (CVD) is responsible for up to 37% of deaths among individuals with CKD, making it a leading cause of mortality among patients with CKD.3 Also, the burden of CVD increases with worsening kidney function and CKD is regarded as a major CVD risk factor.Despite the high burden of CVD among individuals with CKD, the mechanisms underlying the increased prevalence of CVD burden in patients with CKD is not completely known. In addition, little is known about the genetic and
environmental factors that determine the initiation and progression of CVD in patients with CKD. The incidence of CVD is rising in sub-Saharan African
region and CKD is one of the major contributor to this increase.The excess burden of CVD in CKD suggests that both the traditional CVD risk factors
and factors specific to kidney disease play important role in the rising burden of CVD in the population. Among the major kidney disease factors that contribute to the high burden of CVD are Chronic Kidney Disease – Mineral Bone Disease (CKD-MBD), anaemia, hypertension, albuminuria,
endothelial dysfunction, dyslipidemia and peripherial arterial disease.Furthermore, the role of genetic factors in the excess burden of CVD in CKD is yet to be determined. Variants in the gene encoding
Apolipoprotein 1 (APOL1) have been established as the major genetic risk factors for excess of CKD in individuals of African descent. However, their role in excess CVD burden is not clearly defined. This narrative review article examine and discuss thegeneticburden and aetiopathogenesis of CVD among patients with CKD.