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The risk of patients with CKD developing CVD is manifested already in the early stages of CKD development. The impact of declined kidney function on increased cardiovascular risk and the underlying mechanisms are complex and multifactorial. This review discusses the impact of (a) traditional cardiovascular risk factors such as smoking, dyslipidemia, diabetes, and hypertension as well as (b) CKD-specific pathophysiological and molecular mechanisms associated with an increased cardiovascular risk. The latter include uremic toxins, post-translational modifications and uremic lipids, innate immune cell activation and inflammation, oxidative stress, endothelial cell dysfunction, increased coagulation and altered platelet responses, vascular calcification, renin\u2013angiotensin\u2013aldosterone-system (RAAS) and sympathetic activation, as well as anemia. Unraveling the complex interplay of different risk factors, especially in the context of patient subcohorts, will help to find new therapeutic approaches in order to reduce the increased cardiovascular risk in this vulnerable patient cohort.<\/jats:p>","DOI":"10.1007\/s00059-024-05235-4","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T11:03:13Z","timestamp":1709118193000},"page":"95-104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Increased cardiovascular risk in patients with chronic kidney disease","Erh\u00f6htes kardiovaskul\u00e4res Risiko bei Patienten mit chronischer Niereninsuffizienz"],"prefix":"10.1007","volume":"49","author":[{"given":"Sonja","family":"Vondenhoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan J.","family":"Schunk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Noels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"issue":"11","key":"5235_CR1","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1038\/s41581-022-00616-6","volume":"18","author":"K Matsushita","year":"2022","unstructured":"Matsushita\u00a0K et\u00a0al (2022) Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. 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H.\u00a0Noels is founding shareholder of AMICARE Development GmbH.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}