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Mohammed Elsadany, Yifeng Yang, Sonali Gupta, and Joseph Mattana

It has been well known for many years that cardiovascular disease disproportionately affects patients with chronic kidney disease (CKD) and kidney failure, both through acceleration of atherogenesis as a consequence of reduced kidney function and through the various comorbidities with which our patients are frequently afflicted. Despite growing mechanistic insights into kidney–heart interactions, atherogenesis, cardiac hypertrophy, valvular heart disease, and other phenomena and into new therapies that are available, patients with kidney disease continue to experience an excessive burden of cardiovascular disease and events.

Cardiovascular disease, particularly coronary artery disease, is more often a condition of the older individual, but

Mohammed Elsadany, Yifeng Yang, Sonali Gupta, and Joseph Mattana

Until recently, transcatheter aortic valve replacement (TAVR) has been a treatment option for patients with severe symptomatic aortic stenosis who are not candidates for surgical aortic valve replacement (SAVR). It has been used for patients who are at high or intermediate surgical risk, but recent studies have demonstrated the noninferiority and also superiority of TAVR compared with SAVR in patients at low surgical risk (1), and TAVR has found a role in patients with kidney disease as well. The number of TAVR procedures is therefore expected to grow. Whereas kidney disease may have an impact on TAVR outcomes,

Mohammed Elsadany, Yifeng Yang, Sonali Gupta, and Joseph Mattana

Transcatheter mitral valve repair (TMVR) is a minimally invasive procedure used as a treatment option for patients with symptomatic chronic moderate to severe, or severe mitral regurgitation (MR). The MitraClip is an edge-to-edge leaflet repair device and is currently the only device approved by the U.S. Food and Drug Administration for TMVR. MR is one of the most common valve lesions. Patients with chronic kidney disease (CKD) and MR usually have multiple comorbidities, increasing their surgical risk for valve replacement and making them possible candidates for TMVR by use of the MitraClip. The interaction between MR and the kidney is

Yifeng Yang, Mohammed Elsadany, Sonali Gupta, and Joseph Mattana

Dyslipidemia has long been established as a traditional risk factor for cardiovascular disease in the general population. Dyslipidemia, characterized especially by elevated LDL and VLDL, is well known to be associated with higher atherosclerotic cardiovascular disease risk and is a large public health threat.

In patients with chronic kidney disease (CKD) and end stage renal disease (ESRD), cardiovascular disease is accelerated with an even larger impact, compared with the general population. Multiple variables are thought to contribute to this heightened propensity to and accelerated course of cardiovascular disease, including significant alterations in lipoprotein metabolism such as decreased HDL and increased

Mohammed Elsadany, Yifeng Yang, Sonali Gupta, and Joseph Mattana

Patients with chronic kidney disease (CKD) are at higher risk for premature cardiovascular disease and events in comparison with the general population. This appears to result from a complex interplay of various metabolic and vascular factors. There are some underlying differences in the lipid profile of CKD patients versus individuals without CKD. Among them are an abundance of small, dense, atherogenic LDL particles; elevated concentrations of triglycerides; reduced HDL cholesterol concentrations; altered lipoproteins; and the presence of lipoprotein and chylomicron remnants—findings that are characteristic of the lipid profile in this population. Among other variables that affect the heightened propensity of