Manifestations and Risk Factors of Atherosclerosis in Chronic Renal Failure

5 CONTENTS 6 ABBREVIATIONS 8 LIST OF ORIGINAL PUBLICATIONS 9 INTRODUCTION 10 REVIEW OF THE LITERATURE 12 1. Cardiovascular disease in chronic renal failure 12 2. Clinical manifestations of atherosclerotic vascular disease in chronic renal failure 15 2.1. Coronary artery disease 15 Diagnosis of coronary artery disease 16 2.2. Cerebrovascular disease 18 Diagnosis of cerebrovascular disease 18 2.3. Peripheral arterial disease 19 Diagnosis of peripheral arterial disease 19 Medial arterial calcification 20 3. Risk factors for atherosclerosis 22 3.1. General population 22 Homocysteine 23 3.2. Risk factors for atherosclerosis in patients with chronic renal failure 25 Hypertension 25 Diabetes 27 Smoking 27 Dyslipidemia 28 Dyslipidemia, outcome and cardiovascular disease in chronic renal failure 28 Oxidation 33 Inflammation 33 Homocysteine 34 4. Arteriosclerosis in patients with chronic renal failure 37 4.1. Definition 37 4.2. Arterial stiffness 37 4.3. Vascular calcification 38 Effect of calcium-phosphate disorders 39 5. Ultrasound examination of arterial vessels 40 5.1. Carotid artery ultrasound examination 40 5.2 Thoracic aortic examination by using transesophageal echocardiography 41