Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease

Patients with chronic kidney disease are at high and very high risk of cardiovascular disease. As estimated glomerular filtration rate declines, the incidence and severity of risk factors, complications, and atherosclerotic cardiovascular events increase. In this scenario, tailored assessment is the...

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Main Authors: Francesco Perone, Marco Bernardi, Monica Loguercio, Francesca Jacoangeli, Silvia Velardi, Theodora Metsovitis, Federica Ramondino, Matteo Ruzzolini, Marco Ambrosetti
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772487525000248
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author Francesco Perone
Marco Bernardi
Monica Loguercio
Francesca Jacoangeli
Silvia Velardi
Theodora Metsovitis
Federica Ramondino
Matteo Ruzzolini
Marco Ambrosetti
author_facet Francesco Perone
Marco Bernardi
Monica Loguercio
Francesca Jacoangeli
Silvia Velardi
Theodora Metsovitis
Federica Ramondino
Matteo Ruzzolini
Marco Ambrosetti
author_sort Francesco Perone
collection DOAJ
description Patients with chronic kidney disease are at high and very high risk of cardiovascular disease. As estimated glomerular filtration rate declines, the incidence and severity of risk factors, complications, and atherosclerotic cardiovascular events increase. In this scenario, tailored assessment is the key to evaluate the severity of chronic kidney disease and estimate cardiovascular disease risk. Personalized stratification differentiates patients with chronic kidney disease without diabetes mellitus or established atherosclerotic cardiovascular disease in their management and beneficial treatment. Exercise intensity assessment and prescription is suggested to propose specific and safe recommendations for physical activity, training, and cardiac rehabilitation. Programs are based on a combination of endurance and resistance exercise and should be adapted to very high risk chronic kidney disease and haemodialysis patients and after kidney transplantation. Appropriate management of cardiovascular complications in these patients, such as risk factors, heart failure, arrhythmias, and coronary artery disease, is essential to ensure the best treatment and improve the prognosis. Therefore, we propose a critical and comprehensive review to suggest how to manage patients with chronic kidney disease in clinical practice and, specifically, with regard to cardiovascular risk assessment, exercise training prescription, and management of complications.
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series International Journal of Cardiology. Cardiovascular Risk and Prevention
spelling doaj-art-200a0e89a52e47cc9bd4b7ce31cd552c2025-08-20T03:09:44ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-06-012520038610.1016/j.ijcrp.2025.200386Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney diseaseFrancesco Perone0Marco Bernardi1Monica Loguercio2Francesca Jacoangeli3Silvia Velardi4Theodora Metsovitis5Federica Ramondino6Matteo Ruzzolini7Marco Ambrosetti8Cardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, Castel Morrone, 81020, Caserta, Italy; Corresponding author.Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, ItalyCardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta D'Adda, ItalyCardiologia riabilitativa e prevenzione patologie cardiovascolari, USL Umbria1, Perugia, ItalyDivision of Cardiology, University Magna Graecia, Catanzaro, ItalyCatholic University of the Sacred Heart, Rome, ItalyS.C. di Medicina Interna, Azienda Socio Sanitaria Territoriale (ASST) della Brianza, Presidio Ospedaliero di Vimercate, Vimercate, ItalyCardiology Department, Isola Tiberina-Gemelli Isola Hospital, Rome, ItalyCardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta D'Adda, ItalyPatients with chronic kidney disease are at high and very high risk of cardiovascular disease. As estimated glomerular filtration rate declines, the incidence and severity of risk factors, complications, and atherosclerotic cardiovascular events increase. In this scenario, tailored assessment is the key to evaluate the severity of chronic kidney disease and estimate cardiovascular disease risk. Personalized stratification differentiates patients with chronic kidney disease without diabetes mellitus or established atherosclerotic cardiovascular disease in their management and beneficial treatment. Exercise intensity assessment and prescription is suggested to propose specific and safe recommendations for physical activity, training, and cardiac rehabilitation. Programs are based on a combination of endurance and resistance exercise and should be adapted to very high risk chronic kidney disease and haemodialysis patients and after kidney transplantation. Appropriate management of cardiovascular complications in these patients, such as risk factors, heart failure, arrhythmias, and coronary artery disease, is essential to ensure the best treatment and improve the prognosis. Therefore, we propose a critical and comprehensive review to suggest how to manage patients with chronic kidney disease in clinical practice and, specifically, with regard to cardiovascular risk assessment, exercise training prescription, and management of complications.http://www.sciencedirect.com/science/article/pii/S2772487525000248Chronic kidney diseaseCardiovascular diseaseRisk assessmentExercise trainingPhysical activityCardiac rehabilitation
spellingShingle Francesco Perone
Marco Bernardi
Monica Loguercio
Francesca Jacoangeli
Silvia Velardi
Theodora Metsovitis
Federica Ramondino
Matteo Ruzzolini
Marco Ambrosetti
Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
International Journal of Cardiology. Cardiovascular Risk and Prevention
Chronic kidney disease
Cardiovascular disease
Risk assessment
Exercise training
Physical activity
Cardiac rehabilitation
title Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
title_full Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
title_fullStr Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
title_full_unstemmed Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
title_short Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease
title_sort cardiovascular disease risk assessment exercise training and management of complications in patients with chronic kidney disease
topic Chronic kidney disease
Cardiovascular disease
Risk assessment
Exercise training
Physical activity
Cardiac rehabilitation
url http://www.sciencedirect.com/science/article/pii/S2772487525000248
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