Generic placeholder image

Cardiovascular & Hematological Agents in Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 1871-5257
ISSN (Online): 1875-6182

Review Article

Insights into the Association of Chronic Kidney Disease (CKD) and Cardiovascular Risk Among Diabetic vs Non-Diabetic Patients

Author(s): Akashkumar N Singh* and Tatineni Swathi

Volume 21, Issue 1, 2023

Published on: 21 September, 2022

Page: [10 - 19] Pages: 10

DOI: 10.2174/1871525720666220610160310

Price: $65

Abstract

Diabetic patients with chronic kidney disease have a high risk of developing cardiovascular disease-related mortality and morbidity compared to non-diabetic chronic kidney disease patients. The Majority of chronic kidney disease patients with diabetes remain undiagnosed and have a higher incidence of cardiovascular comorbidities even when they do not progress to endstage renal failure. Both traditional cardiovascular risk factors and non-traditional cardiovascular risk factors are known to be present in a higher magnitude in diabetic patients with chronic kidney disease and are known to partially account for the increased incidence of cardiovascular disease compared to non-diabetic chronic kidney disease patients. Moreover, there is no definitive evidence for potential therapeutic treatment options for cardiovascular disease among diabetic patients with chronic kidney disease, as these patients have often not been included in major cardiovascular trials. Therefore, there is a need to recognize diabetic patients with chronic kidney disease patients having a high cardiovascular disease risk for definite and immediate medical attention at an individual patient level. Increased awareness, timely diagnosis, and intervention with respect to control these plays a pivotal role in avoiding undesirable cardiovascular disease events and lead to improved treatment outcomes among these patients. Further research is warranted to understand the risk factors for cardiovascular disease and to develop and implement preventive and treatment strategies to decrease the high morbidity and mortality among diabetic patients with chronic kidney disease. This review summarizes the available epidemiological data, and risk factors, discusses clinical presentations, and suggests prevention and management strategies for cardiovascular disease risk among diabetic patients with chronic kidney disease.

Keywords: Chronic kidney disease, diabetes mellitus and cardiovascular disease, epidemiological data, diabetic patient, timely diagnosis, Covid-19.

Graphical Abstract

[1]
Bright, R. Cases and observations illustrative of renal disease accompanied with the secretion of albuminous urine. Guy’s Hospital Trans., 1836, 1, 338-379.
[2]
Harlos, J.; Heidland, A. Hypertension as cause and consequence of renal disease in the 19th century. Am. J. Nephrol., 1994, 14(4-6), 436-442.
[http://dx.doi.org/10.1159/000168761] [PMID: 7847482]
[3]
Lovre, D.; Shah, S.; Sihota, A.; Fonseca, V.A. Managing diabetes and cardiovascular risk in chronic kidney disease patients. Endocrinol. Metab. Clin. North Am., 2018, 47(1), 237-257.
[http://dx.doi.org/10.1016/j.ecl.2017.10.006] [PMID: 29407054]
[4]
Alani, H.; Tamimi, A.; Tamimi, N. Cardiovascular co-morbidity in chronic kidney disease: Current knowledge and future research needs. World J. Nephrol., 2014, 3(4), 156-168.
[http://dx.doi.org/10.5527/wjn.v3.i4.156] [PMID: 25374809]
[5]
Gansevoort, R.T. Global kidney disease 5: Chronic kidney disease and cardiovascular risk: Epidemiology, mechanisms, and prevention. The Lancet, 2013, 382(9889), 339-352.
[6]
Pálsson, R.; Patel, U.D. Cardiovascular complications of diabetic kidney disease. Adv. Chronic Kidney Dis., 2014, 21(3), 273-280.
[http://dx.doi.org/10.1053/j.ackd.2014.03.003] [PMID: 24780455]
[7]
Yuan, Jun Prevalence and risk factors for cardiovascular disease among chronic kidney disease patients: Results from the Chinese cohort study of chronic kidney disease (C-STRIDE). BMC Nephrol., 2017, 18, 23.
[8]
Shulman, N.B.; Ford, C.E.; Hall, W.D.; Blaufox, M.D.; Simon, D.; Langford, H.G.; Schneider, K.A. Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results from the hypertension detection and follow-up program. Hypertension, 1989, 13(5), I80-I93.
[http://dx.doi.org/10.1161/01.HYP.13.5_Suppl.I80] [PMID: 2490833]
[9]
Levey, A.S.; Beto, J.A.; Coronado, B.E.; Eknoyan, G.; Foley, R.N.; Kasiske, B.L.; Klag, M.J.; Mailloux, L.U.; Manske, C.L.; Meyer, K.B.; Parfrey, P.S.; Pfeffer, M.A.; Wenger, N.K.; Wilson, P.W.; Wright, J.T., Jr Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am. J. Kidney Dis., 1998, 32(5), 853-906.
[http://dx.doi.org/10.1016/S0272-6386(98)70145-3] [PMID: 9820460]
[10]
Jungers, P.; Massy, Z.A.; Nguyen Khoa, T.; Fumeron, C.; Labrunie, M.; Lacour, B.; Descamps-Latscha, B.; Man, N.K. Incidence and risk factors of atherosclerotic cardiovascular accidents in predialysis chronic renal failure patients: A prospective study. Nephrol. Dial. Transplant., 1997, 12(12), 2597-2602.
[http://dx.doi.org/10.1093/ndt/12.12.2597] [PMID: 9430858]
[11]
Locatelli, F.; Pozzoni, P.; Tentori, F.; del Vecchio, L. Epidemiology of cardiovascular risk in patients with chronic kidney disease. Nephrol. Dial. Transplant., 2003, 18(Suppl. 7), vii2-vii9.
[http://dx.doi.org/10.1093/ndt/gfg1072] [PMID: 12953023]
[12]
Culleton, B.F.; Larson, M.G.; Wilson, P.W.; Evans, J.C.; Parfrey, P.S.; Levy, D. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int., 1999, 56(6), 2214-2219.
[http://dx.doi.org/10.1046/j.1523-1755.1999.00773.x] [PMID: 10594797]
[13]
Levin, A.; Singer, J.; Thompson, C.R.; Ross, H.; Lewis, M. Prevalent left ventricular hypertrophy in the predialysis population: Identifying opportunities for intervention. Am. J. Kidney Dis., 1996, 27(3), 347-354.
[http://dx.doi.org/10.1016/S0272-6386(96)90357-1] [PMID: 8604703]
[14]
London, G.M. Cardiovascular disease in chronic renal failure: Pathophysiologic aspects. Semin. Dial., 2003, 16(2), 85-94.
[http://dx.doi.org/10.1046/j.1525-139X.2003.16023.x] [PMID: 12641870]
[15]
Foley, R.N.; Wang, C.; Collins, A.J. Cardiovascular risk factor profiles and kidney function stage in the US general population: The NHANES III study. Mayo Clin. Proc., 2005, 80(10), 1270-1277.
[http://dx.doi.org/10.4065/80.10.1270] [PMID: 16212138]
[16]
Becker, B.; Kronenberg, F.; Kielstein, J.T.; Haller, H.; Morath, C.; Ritz, E.; Fliser, D. Renal insulin resistance syndrome, adiponectin and cardiovascular events in patients with kidney disease: The mild and moderate kidney disease study. J. Am. Soc. Nephrol., 2005, 16(4), 1091-1098.
[http://dx.doi.org/10.1681/ASN.2004090742] [PMID: 15743998]
[17]
Chan, M.Y.; Becker, R.C.; Sim, L.L.; Tan, V.; Lee, C.H.; Low, A.F.; Teo, S.G.; Ng, K.S.; Tan, H.C.; Yeo, T.C. Reperfusion strategy and mortality in ST-elevation myocardial infarction among patients with and without impaired renal function. Ann. Acad. Med. Singap., 2010, 39(3), 179-184.
[PMID: 20372752]
[18]
Ahmed, A.; Rich, M.W.; Sanders, P.W.; Perry, G.J.; Bakris, G.L.; Zile, M.R.; Love, T.E.; Aban, I.B.; Shlipak, M.G. Chronic kidney disease associated mortality in diastolic versus systolic heart failure: A propensity matched study. Am. J. Cardiol., 2007, 99(3), 393-398.
[http://dx.doi.org/10.1016/j.amjcard.2006.08.042] [PMID: 17261405]
[19]
Toyoda, K.; Fujii, K.; Ando, T.; Kumai, Y.; Ibayashi, S.; Iida, M. Incidence, etiology, and outcome of stroke in patients on continuous ambulatory peritoneal dialysis. Cerebrovasc. Dis., 2004, 17(2-3), 98-105.
[http://dx.doi.org/10.1159/000075776] [PMID: 14707407]
[20]
K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am. J. Kidney Dis., 2005, 45(4)(Suppl. 3), S1-S153.
[PMID: 15806502]
[21]
Go, A.S.; Fang, M.C.; Udaltsova, N.; Chang, Y.; Pomernacki, N.K.; Borowsky, L.; Singer, D.E. Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: The anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Circulation, 2009, 119(10), 1363-1369.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.816082] [PMID: 19255343]
[22]
Lash, J.P.; Go, A.S.; Appel, L.J.; He, J.; Ojo, A.; Rahman, M.; Townsend, R.R.; Xie, D.; Cifelli, D.; Cohan, J.; Fink, J.C.; Fischer, M.J.; Gadegbeku, C.; Hamm, L.L.; Kusek, J.W.; Landis, J.R.; Narva, A.; Robinson, N.; Teal, V.; Feldman, H.I. Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline characteristics and associations with kidney function. Clin. J. Am. Soc. Nephrol., 2009, 4(8), 1302-1311.
[http://dx.doi.org/10.2215/CJN.00070109] [PMID: 19541818]
[23]
Pun, P.H.; Smarz, T.R.; Honeycutt, E.F.; Shaw, L.K.; Al-Khatib, S.M.; Middleton, J.P. Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease. Kidney Int., 2009, 76(6), 652-658.
[http://dx.doi.org/10.1038/ki.2009.219] [PMID: 19536082]
[24]
Yan, Y.L.; Qiu, B.; Wang, J.; Deng, S.B.; Wu, L.; Jing, X.D.; Du, J.L.; Liu, Y.J.; She, Q. High-intensity statin therapy in patients with chronic kidney disease: A systematic review and meta-analysis. BMJ Open, 2015, 5(5)e006886
[http://dx.doi.org/10.1136/bmjopen-2014-006886] [PMID: 25979868]
[25]
Scarpioni, R.; Ricardi, M.; Albertazzi, V.; Melfa, L. Treatment of dyslipidemia in chronic kidney disease: Effectiveness and safety of statins. World J. Nephrol., 2012, 1(6), 184-194.
[http://dx.doi.org/10.5527/wjn.v1.i6.184] [PMID: 24175258]
[26]
Chonchol, M.; Cook, T.; Kjekshus, J.; Pedersen, T.R.; Lindenfeld, J. Simvastatin for secondary prevention of all-cause mortality and major coronary events in patients with mild chronic renal insufficiency. Am. J. Kidney Dis., 2007, 49(3), 373-382.
[http://dx.doi.org/10.1053/j.ajkd.2006.11.043] [PMID: 17336698]
[27]
Tonelli, M.; Keech, A.; Shepherd, J.; Sacks, F.; Tonkin, A.; Packard, C.; Pfeffer, M.; Simes, J.; Isles, C.; Furberg, C.; West, M.; Craven, T.; Curhan, G. Effect of pravastatin in people with diabetes and chronic kidney disease. J. Am. Soc. Nephrol., 2005, 16(12), 3748-3754.
[http://dx.doi.org/10.1681/ASN.2005070779] [PMID: 16251235]
[28]
Heart Protection Study Collaborative Group. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: A randomised placebo-controlled trial. Lancet, 2002, 360(9326), 7-22.
[http://dx.doi.org/10.1016/S0140-6736(02)09327-3] [PMID: 12114036]
[29]
Wanner, C.; Krane, V.; März, W.; Olschewski, M.; Mann, J.F.; Ruf, G.; Ritz, E. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N. Engl. J. Med., 2005, 353(3), 238-248.
[http://dx.doi.org/10.1056/NEJMoa043545] [PMID: 16034009]
[30]
Fellström, B.C.; Jardine, A.G.; Schmieder, R.E.; Holdaas, H.; Bannister, K.; Beutler, J.; Chae, D.W.; Chevaile, A.; Cobbe, S.M.; Grönhagen-Riska, C.; De Lima, J.J.; Lins, R.; Mayer, G.; McMahon, A.W.; Parving, H.H.; Remuzzi, G.; Samuelsson, O.; Sonkodi, S.; Sci, D.; Süleymanlar, G.; Tsakiris, D.; Tesar, V.; Todorov, V.; Wiecek, A.; Wüthrich, R.P.; Gottlow, M.; Johnsson, E.; Zannad, F. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N. Engl. J. Med., 2009, 360(14), 1395-1407.
[http://dx.doi.org/10.1056/NEJMoa0810177] [PMID: 19332456]
[31]
Sarafidis, P.; Ferro, C.J.; Morales, E.; Ortiz, A.; Malyszko, J.; Hojs, R.; Khazim, K.; Ekart, R.; Valdivielso, J.; Fouque, D.; London, G.M.; Massy, Z.; Ruggenenti, P.; Porrini, E.; Wiecek, A.; Zoccali, C.; Mallamaci, F.; Hornum, M. SGLT-2 inhibitors and GLP-1 receptor agonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease. A consensus statement by the EURECA-m and the DIABESITY working groups of the ERA-EDTA. Nephrol. Dial. Transplant., 2019, 34(2), 208-230.
[http://dx.doi.org/10.1093/ndt/gfy407] [PMID: 30753708]
[32]
Perkovic, V.; Jardine, M.J.; Neal, B.; Bompoint, S.; Heerspink, H.J.L.; Charytan, D.M.; Edwards, R.; Agarwal, R.; Bakris, G.; Bull, S.; Cannon, C.P.; Capuano, G.; Chu, P.L.; de Zeeuw, D.; Greene, T.; Levin, A.; Pollock, C.; Wheeler, D.C.; Yavin, Y.; Zhang, H.; Zinman, B.; Meininger, G.; Brenner, B.M.; Mahaffey, K.W. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N. Engl. J. Med., 2019, 380(24), 2295-2306.
[http://dx.doi.org/10.1056/NEJMoa1811744] [PMID: 30990260]
[33]
Luis Górriz, J.; Navarro-González, J.F.; Ortiz, A.; Vergara, A.; Nuñez, J.; Jacobs-Cachá, C.; Martínez-Castelao, A.; Jose Soler, M. Sodium-glucose cotransporter 2 inhibition: Towards an indication to treat diabetic kidney disease. Nephrol. Dial. Transplant., 2020, 35, i13-i23.
[34]
Heerspink, H.J.L.; Stefansson, B.V.; Chertow, G.M.; Correa-Rotter, R.; Greene, T.; Hou, F.F.; Lindberg, M.; McMurray, J.; Rossing, P.; Toto, R.; Langkilde, A.M.; Wheeler, D.C. Rationale and protocol of the dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) randomized controlled trial. Nephrol. Dial. Transplant., 2020, 35(2), 274-282.
[http://dx.doi.org/10.1093/ndt/gfz290] [PMID: 32030417]
[35]
Packer, M.; Anker, S.D.; Butler, J.; Filippatos, G.; Pocock, S.J.; Carson, P.; Januzzi, J.; Verma, S.; Tsutsui, H.; Brueckmann, M.; Jamal, W.; Kimura, K.; Schnee, J.; Zeller, C.; Cotton, D.; Bocchi, E.; Böhm, M.; Choi, D.J.; Chopra, V.; Chuquiure, E.; Giannetti, N.; Janssens, S.; Zhang, J.; Gonzalez Juanatey, J.R.; Kaul, S.; Brunner-La Rocca, H.P.; Merkely, B.; Nicholls, S.J.; Perrone, S.; Pina, I.; Ponikowski, P.; Sattar, N.; Senni, M.; Seronde, M.F.; Spinar, J.; Squire, I.; Taddei, S.; Wanner, C.; Zannad, F. Cardiovascular and renal outcomes with empagliflozin in heart failure. N. Engl. J. Med., 2020, 383(15), 1413-1424.
[http://dx.doi.org/10.1056/NEJMoa2022190] [PMID: 32865377]
[36]
Greco, E.V.; Russo, G.; Giandalia, A.; Viazzi, F.; Pontremoli, R.; De Cosmo, S. GLP-1 receptor agonists and kidney protection. Medicina (Kaunas), 2019, 55(6), 233.
[37]
Kristensen, S.L.; Rørth, R.; Jhund, P.S.; Docherty, K.F.; Sattar, N.; Preiss, D.; Køber, L.; Petrie, M.C.; McMurray, J.J.V. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol., 2019, 7(10), 776-785.
[http://dx.doi.org/10.1016/S2213-8587(19)30249-9] [PMID: 31422062]
[38]
Liu, M.; Li, X.C.; Lu, L.; Cao, Y.; Sun, R.R.; Chen, S.; Zhang, P.Y. Cardiovascular disease and its relationship with chronic kidney disease. Eur. Rev. Med. Pharmacol. Sci., 2014, 18(19), 2918-2926.
[PMID: 25339487]
[39]
Keltai, M.; Tonelli, M.; Mann, J.F.; Sitkei, E.; Lewis, B.S.; Hawken, S.; Mehta, S.R.; Yusuf, S. Renal function and outcomes in acute coronary syndrome: Impact of clopidogrel. Eur. J. Cardiovasc. Prev. Rehabil., 2007, 14(2), 312-318.
[http://dx.doi.org/10.1097/01.hjr.0000220582.19516.a6] [PMID: 17446813]
[40]
Berger, A.K.; Duval, S.; Krumholz, H.M. Aspirin, beta-blocker, and angiotensin-converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction. J. Am. Coll. Cardiol., 2003, 42(2), 201-208.
[http://dx.doi.org/10.1016/S0735-1097(03)00572-2] [PMID: 12875751]
[41]
Tsai, T.T.; Maddox, T.M.; Roe, M.T.; Dai, D.; Alexander, K.P.; Ho, P.M.; Messenger, J.C.; Nallamothu, B.K.; Peterson, E.D.; Rumsfeld, J.S. Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention. JAMA, 2009, 302(22), 2458-2464.
[http://dx.doi.org/10.1001/jama.2009.1800] [PMID: 19996401]
[42]
Bavry, A.A.; Kumbhani, D.J.; Rassi, A.N.; Bhatt, D.L.; Askari, A.T. Benefit of early invasive therapy in acute coronary syndromes: A meta-analysis of contemporary randomized clinical trials. J. Am. Coll. Cardiol., 2006, 48(7), 1319-1325.
[http://dx.doi.org/10.1016/j.jacc.2006.06.050] [PMID: 17010789]
[43]
Anderson, J.L.; Adams, C.D.; Antman, E.M.; Bridges, C.R.; Califf, R.M.; Casey, D.E., Jr; Chavey, W.E., II; Fesmire, F.M.; Hochman, J.S.; Levin, T.N.; Lincoff, A.M.; Peterson, E.D.; Theroux, P.; Wenger, N.K.; Wright, R.S.; Smith, S.C., Jr; Jacobs, A.K.; Halperin, J.L.; Hunt, S.A.; Krumholz, H.M.; Kushner, F.G.; Lytle, B.W.; Nishimura, R.; Ornato, J.P.; Page, R.L.; Riegel, B. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2007, 116(7), e148-e304.
[PMID: 17679616]
[44]
Charytan, D.M.; Wallentin, L.; Lagerqvist, B.; Spacek, R.; De Winter, R.J.; Stern, N.M.; Braunwald, E.; Cannon, C.P.; Choudhry, N.K. Early angiography in patients with chronic kidney disease: A collaborative systematic review. Clin. J. Am. Soc. Nephrol., 2009, 4(6), 1032-1043.
[http://dx.doi.org/10.2215/CJN.05551008] [PMID: 19423566]
[45]
Fraker, T.D., Jr; Fihn, S.D.; Gibbons, R.J.; Abrams, J.; Chatterjee, K.; Daley, J.; Deedwania, P.C.; Douglas, J.S.; Ferguson, T.B., Jr; Fihn, S.D.; Fraker, T.D., Jr; Gardin, J.M.; O’Rourke, R.A.; Williams, S.V.; Smith, S.C., Jr; Jacobs, A.K.; Adams, C.D.; Anderson, J.L.; Buller, C.E.; Creager, M.A.; Ettinger, S.M.; Halperin, J.L.; Hunt, S.A.; Krumholz, H.M.; Kushner, F.G.; Lytle, B.W.; Nishimura, R.; Page, R.L.; Riegel, B.; Tarkington, L.G.; Yancy, C.W. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation, 2007, 116(23), 2762-2772.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.107.187930] [PMID: 17998462]
[46]
Ix, J.H.; Mercado, N.; Shlipak, M.G.; Lemos, P.A.; Boersma, E.; Lindeboom, W.; O’Neill, W.W.; Wijns, W.; Serruys, P.W. Association of chronic kidney disease with clinical outcomes after coronary revascularization: The Arterial Revascularization Therapies Study (ARTS). Am. Heart J., 2005, 149(3), 512-519.
[http://dx.doi.org/10.1016/j.ahj.2004.10.010] [PMID: 15864241]
[47]
Liu, J.Y.; Birkmeyer, N.J.; Sanders, J.H.; Morton, J.R.; Henriques, H.F.; Lahey, S.J.; Dow, R.W.; Maloney, C.; DiScipio, A.W.; Clough, R.; Leavitt, B.J.; O’Connor, G.T. Risks of morbidity and mortality in dialysis patients undergoing coronary artery bypass surgery. Circulation, 2000, 102(24), 2973-2977.
[http://dx.doi.org/10.1161/01.CIR.102.24.2973] [PMID: 11113048]
[48]
Charytan, D.M.; Kuntz, R.E. Risks of coronary artery bypass surgery in dialysis-dependent patients-analysis of the 2001 National Inpatient Sample. Nephrol. Dial. Transplant., 2007, 22(6), 1665-1671.
[http://dx.doi.org/10.1093/ndt/gfl835] [PMID: 17299001]
[49]
Cooper, W.A.; O’Brien, S.M.; Thourani, V.H.; Guyton, R.A.; Bridges, C.R.; Szczech, L.A.; Petersen, R.; Peterson, E.D. Impact of renal dysfunction on outcomes of coronary artery bypass surgery: Results from the Society of Thoracic Surgeons National Adult Cardiac Database. Circulation, 2006, 113(8), 1063-1070.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.105.580084] [PMID: 16490821]
[50]
Herzog, C.A.; Ma, J.Z.; Collins, A.J. Comparative survival of dialysis patients in the United States after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery and impact of diabetes. Circulation, 2002, 106(17), 2207-2211.
[http://dx.doi.org/10.1161/01.CIR.0000035248.71165.EB] [PMID: 12390949]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy