Chronic Kidney Disease ( Ckd )

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Introduction 1.1 Chronic kidney disease Chronic kidney disease (CKD) is global health problem with increasing incidence and economic burden every year. CKD is defined as decreased in glomerular filtration rate with albuminuria (Jha et al., 2013). Jha et al., 2013 estimate that the worldwide prevalence of CKD is 8-16% with higher incidence among poorer populations. Among the whole world countries, the highest end stage renal disease prevalence is in Taiwan (Chan et al., 2014). Diabetes mellitus is considered to be the most common cause of chronic renal diseases (Jha et al., 2013). Complications of chronic renal disease include anaemia, mineral and bone disorders, reduced cognitive ability, progression to the end stage renal disease and on top of these complication is increased risk of cardiovascular diseases morbidity and mortality (Jha et al., 2013). 1.2 Chronic renal disease and cardiovascular disease Chronic kidney disease is accompanied by increased risk of cardiovascular diseases such as arrhythmia, peripheral arterial diseases, ischaemic heart diseases and sudden cardiac death (Lullo et al., 2015 & Jha et al., 2013). Richard Bright was the first who report the association between chronic renal disease and cardiovascular diseases in 1836. (Santoro and Mandreoli, 2014). Cardiovascular diseases are the major cause of death among advanced chronic kidney disease patients. (Santoro and Mandreoli, 2014) regardless the progression to the end stage renal disease (Trappenburg
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