Perspectives in Managing Kidney Disease and Atherosclerotic Cardiovascular Disease.

Abstract

Introduction: Chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) share a complex and dependent link with each other and other cardiometabolic conditions. Currently, there is insufficient data regarding patient and provider perceptions about this important clinical overlap. This study sought to evaluate healthcare provider (HCP) and patient attitudes and perceptions about CKD and ASCVD, including risk, diagnosis, and management of both conditions.

Methods: Cross-sectional surveys of 58 nephrologists and 74 cardiologists who treat patients with CKD and ASCVD and 195 patients who self-reported having CKD and ASCVD were conducted in the USA between May and June 2021.

Results: Most nephrologists agreed that the presence of cardiometabolic comorbidities increased patients' risk of developing CKD; 86% agreed that type 2 diabetes increased the risk, and 67% agreed that ASCVD increased the risk. However, only 52% of the nephrologists reported they typically discuss the risk of developing CKD with patients prior to diagnosing them. Slightly more than one-third of patients (35%) reported their HCP discussed other conditions' impact on the development of CKD; of all HCPs surveyed, nephrologists were the least likely to discuss CKD risk with their patients. Most nephrologists (83%) also reported they recommended lifestyle modification to patients; however, only about half of patients (53%) reported they were currently using a lifestyle change to treat CKD and/or ASCVD.

Conclusion: Although CKD and ASCVD are known to have a bidirectional relationship, HCPs in our study did not report routinely educating patients about the risk of developing one or both conditions. As HCPs with perhaps the deepest understanding of the interplay between CKD and cardiorenal comorbidities, nephrologists are well positioned to help patients understand the link between cardiovascular and renal health, help identify strategies to limit risk, and appropriately treat the conditions.