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Last Updated 7/11/10
 

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The leading cause of death for end-stage renal disease patients is cardiovascular disease (CVD).  Approximately 16,000 dialysis patients die each year (1996) from CVD according to the United States Renal Data System (USRDS).  This risk for CVD is about 30 times the risk in the general population.  Even after statistical adjustments to account for age, CVD-related deaths remain 10 to 20 times higher than in the general population.

The high risk of CVD in end-stage renal disease is partly due to the fact that the dialysis patient population has a higher prevalence of conditions that are known risk factors for CVD in the general population, such as older age, hypertension (high blood pressure), high cholesterol levels, diabetes, and physical inactivity. The high risk may also be partly caused by factors involved in renal failure, including proteinuria (protein in urine), fluid retention, irregular blood chemistries, anemia, blood clotting disorders, and chronic inflammation.

The two most common CVD conditions seen in patients with end-stage renal disease are coronary artery disease (CAD) and left ventricular hypertrophy (LVH).  The physical symptoms of these two conditions may often be the same, and include chest pain, heart attack, congestive heart failure, and arrhythmias.

Warning:  Changes should never be made in a patient's treatment or care based solely on the information found here.  Every patient has unique healthcare concerns and considerations and all these factors must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.


  NEWS & LATEST ARTICLES
Coronary Artery Calcification and Coronary Ischemia in Renal Transplant Recipients - Advance Access abstract from NDT. - July 9, 2010
Statin Lowers Cardiac Events in Diabetics on Hemodialysis With High Cholesterol Levels - Article from Medscape Today. - July 8, 2010
Kidney Stones Associate with Increased Risk for Myocardial Infarction - Abstract from JASN. - July 8, 2010
Heart Beat Could Provide Marker for Kidney Health: Study - Article from HealthDay. - July 8, 2010
Monitoring Blood Pressure at Home May Help Keep It Low - Article from HealthDay. - July 7, 2010
Tradeoffs With CABG Vs Stenting in Patients With Kidney Disease - Article from Medscape Today. - July 7, 2010
Predicting cardiovascular disease morbidity and mortality in chronic kidney disease in Spain. The rationale and design of NEFRONA: a prospective, multicenter, observational cohort study - Abstract from BMC Nephrology. - July 7, 2010
The Redox State of Albumin and Serious Cardiovascular Incidence in Hemodialysis Patients - Early View abstract from Therapeutic Apheresis and Dialysis. - July 6, 2010
Allopurinol Regresses Left Ventricular Hypertrophy in Chronic Kidney Disease - Article from Medscape Today. - July 6, 2010
Tight Blood Pressure Control Doesn't Help All Diabetics: Study - Article from HealthDay. - July 6, 2010
Oral Nicorandil Greatly Lowers Risk for Death in Hemodialysis Patients - Article from Medscape Today. - July 7, 2010
Pitt researchers find new proteins that regulate blood pressure, flow - University of Pittsburgh Schools of the Health Sciences . - July 7, 2010
High blood pressure expected to affect 1.56 billion people by 2025 - Article from My Sinchew. - July 7, 2010
One year experience of nocturnal home haemodialysis with an alternate night schedule in Hong Kong - Abstract from Nephrology. - July 5, 2010
The Relationship of the Course of Depression Symptoms with the Left Ventricular Mass Index and Left Ventricular Filling Pressure in Chronic Hemodialysis Patients - Accepted Article abstract from Nephrology. - July 5, 2010
Lanthanum Carbonate Provides Control of Phosphorus Levels in Patients New to Phosphate Binder Therapy and Patients Changed From Other Phosphate Binders - Abstract from the Journal of Renal Nutrition. - July 5, 2010
Atorvastatin Beats Rosuvastatin in Protecting Kidneys in Diabetic and Nondiabetic Patients - Article from Medscape Today. - July 2, 2010
UPDATE 1-Impax files for generic version of Genzyme's Renvela - Article from Reuters. - July 2, 2010
FDA Class I (Highest Risk) Recall: LIFEPAK 20 and LIFEPAK 20e External Defibrillator/Monitors by Physio-Control - Recall notice from the U.S. Food and Drug Administration. - July 2, 2010
The Effects of Vitamin D Therapy on Left Ventricular Structure and Function – Are These the Underlying Explanations for Improved CKD Patient Survival - Free, full-text, Issue-in-Progress article from Nephron Clinical Practice. Also see this story from the Endocrine Society: - July 2, 2010
Low vitamin D linked to the metabolic syndrome in elderly people
Elevated Preoperative Phosphorus Levels Are an Independent Risk Factor for Cardiovascular Mortality - Abstract from the American Journal of Nephrology. - July 1, 2010
ACE Inhibitors and PD - Blog entry from Renal Fellow Network. - July 1, 2010
Prognostic Value of Reduced Left Ventricular Ejection Fraction at Start of Hemodialysis Therapy on Cardiovascular and All-Cause Mortality in End-Stage Renal Disease Patients - CJASN Express abstract. - July 1, 2010
Study: High-Fructose Diets May Raise Blood Pressure - Article from WebMD. - July 1, 2010
Health-Related Quality of Life in Hypertension, Chronic Kidney Disease, and Coexistent Chronic Health Conditions - Free, full-text article from Advances in Chronic Kidney Disease. - July 2010
Malnutrition-Inflammation Score Independently Determined Cardiovascular and Infection Risk in Peritoneal Dialysis Patients - Issue-in-Progress abstract from Blood Purification. - July 2010
Blacks Hospitalized for High Blood Pressure Five Times More Often Than Whites - News release. - June 30, 2010
ADA: Mortality Lower with Metformin - Article from Medpage Today. - June 30, 2010
Target haemoglobin to aim for with erythropoiesis-stimulating agents: a position statement by ERBP following publication of the Trial to Reduce Cardiovascular Events with Aranesp® Therapy (TREAT) Study - Advance Access abstract from NDT. - June 29, 2010
Are Peritoneal Calcifications in Long-Term PD Patient Related to Aortic Calcifications and Disturbances in Mineral Metabolism? - Advance Access abstract from NDT. - June 29, 2010
Near-normal blood sugar target did not delay risk of organ damage in people with diabetes - Article from NIH. - June 29, 2010
Skin autofluorescence is associated with renal function and cardiovascular diseases in pre-dialysis chronic kidney disease patients - Advance Access abstract from NDT . - June 29, 2010
Gout Drug May Decrease LVH in CKD Patients - Article from Renal & Urology News. - June 29, 2010
ADA: Diabetes and Cardiology Groups Stay Firm on Rosiglitazone - Article from Medpage Today. - June 29, 2010
Association of Serum Phosphorus With Left Ventricular Mass in Men and Women With Stable Cardiovascular Disease: Data From the Heart and Soul Study - Article from AKJD. - June 28, 2010
Aggressive control of cardiac risk factors might not benefit all patients with diabetes - Article from JAMA and Archives Journal. - June 28, 2010
Vanderbilt Nephrologist Says Lower BP Guideline Has Unproven Benefit and Safety - Press release. - June 28, 2010
Influence of Physicians' Management and Communication Ability on Patients' Persistence With Antihypertensive Medication - Abstract from the Archives of Internal Medicine. - June 28, 2010
Dark chocolate lowers blood pressure - Article from Biomed Central. - June 28, 2010
Study raises questions over wider use of statins - Article from Reuters. - June 28, 2010
Two Dramatically Different Stories on Diabetes Drug Avandia (Rosiglitazone) - June 28, 2010
Diabetes Drug Avandia Ups Heart Risk, Reviews Conclude
Articles from HealthDay and MedPage Today. Press release and free,full-text, Early Release article from the Journal of the American Medical Association. Press release and free, full-text article from Archives of Internal Medicine.
ADA: Rosiglitazone May Benefit CVD Patients
Article and video from MedPage Today.
ADA: Diabetes Responsible for 10% of Vascular Deaths - Article from Medpage Today. - June 25, 2010
FDA: Cardiovascular and Renal Drugs Advisory Committee Meeting Announcement - The July 29th meeting will discuss Revatio (sildenafil) for the treatment of pediatric pulmonary arterial hypertension. - June 25, 2010
Sympathetic overactivity and sudden cardiac death among hemodialysis patients with left ventricular hypertrophy - Article from International Journal of Cardiology. - June 25, 2010
Systemic blood pressure profile in hypertensive patients with low hemoglobin concentrations - Article from International Journal of Cardiology. - June 25, 2010
Association between routine and standardized blood pressure measurements and left ventricular hypertrophy among patients on hemodialysis - Provisional abstract from BMC Nephrology. - June 24, 2010
Diabetes Doubles Risk of Heart Attack, Stroke - Article from WebMD. - June 24, 2010
Despite the Guidelines, Lower Blood Pressure Might Be Unhealthy for Kidney Patients - ASN Press release and JASN Express abstract. - June 24, 2010
The Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) Study: Objectives, Design, and Methodology - CJASN Express abstract. - June 24, 2010
Increment of monthly mean predialysis heart rate reflects early cardiac overload in hemodialysis patients with normal cardiac function - Abstract from Journal of Nephrology. - June 23, 2010
Cardiovascular events in chronic dialysis patients: emphasizing the importance of vascular disease prevention - Article from International Urology & Nephrology. - June 23, 2010
Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients - Provisional abstract from BMC Nephrology. - June 21, 2010
Hypertension Strongest Predictor of Stroke - Article from Medpage Today. - June 21, 2010
Cardiovascular Risk in the Peritoneal Dialysis Patient - Advance online abstract from Nature Reviews Nephrology. - June 22, 2010
No salt, no hypertension - Blog article from the Renal Fellow Network. - June 19, 2010
Calf Bioimpedance Ratio Improves Dry Weight Assessment and Blood Pressure Control in Hemodialysis Patients - Article from the American Journal of Nephrology. - June 18, 2010
Cinacalcet hydrochloride treatment significantly improves all-cause and cardiovascular survival in a large cohort of hemodialysis patients - Advance online abstract from Kidney International. - June 16, 2010
The Association Between Ankle-Brachial Index and Quality of Life in Chronic Hemodialysis Patients - Abstract from Angiology. - June 16, 2010
Long and short-term outcomes following coronary artery bypass grafting in patients with and without chronic kidney disease - Advanced Access abstract from NDT. - June 15, 2010
Dyslipidemia in Chronic Kidney Disease: Are Statins Still Indicated in Reduction Cardiovascular Risk in Patients on Dialysis Treatment? - Abstract from Cardiovascular Therapeutics. - June 14, 2010
Blood Pressure Drugs Linked to Cancer Risk - Article from Medpage Today. - June 13, 2010
Class I Recall of Defibtech ReviveR AED™ and Lifeline AED Defibrillator Battery Packs - Notice from the FDA. - May 21, 2010
News Releases from the American Heart Association  Continually Updated!
Newsworthy Events and New Features - from the American Heart Association Continually Updated!
Latest Cardiovascular Disease News Stories - Yahoo! News Continually Updated!
Latest Hypertension News Stories - Yahoo! News Continually Updated!
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  WEB RESOURCES
Latest Scientific Journal Articles on Cardiovascular Disease - list compiled by RenalWEB's Journal Watch
Acute and Chronic Management of Atrial Fibrillation in Patients With Late-Stage CKD - Full-text article from the American Journal of Kidney Diseases. - April 2009
Cardiovascular Disease in ESRD: Special Study Center from the United States Renal Data Center (USRDS). USRDS Cardiovascular Presentations and Posters.
Cardiovascular disease calculators - subject page from RenalWEB
Cardiovascular Disease in Children with CKD or ESRD - Free, full-text article from Nature Reviews Nephrology. - April 2009
Cardiovascular complications of pediatric chronic kidney disease - educational feature from Pediatric Nephrology - February 2008
Cause or Casualty? The Impact and Role of the Kidney on Inflammation, Metabolic Syndrome and Atherogenesis (pdf) free CE program from the National Kidney Foundation (NKF) web site
Diseases & Conditions from the American Heart Association web site
Evaluation of cardiac function in the dialysis patient—a primer for the non-expert - editorial from Nephrology Dialysis Transplantation - June 2006
The Guide to Medicare Preventive Services (pdf) from the Medlearn/Centers for Medicare & Medicaid Services web site
High Blood Pressure and Kidney Disease: How Are They Connected? web cast from the Kidney & Urology Foundation of America (KUFA) web site
Hypertension Review CEU activity from the Kidney Learning System web site
National Cholesterol Education Program (NCEP) web site. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
Webcast CME: Cardiovascular Disease in CKD from Doctor's Guide
The Well-Controlled Patient: Looking Beyond the Lab Tests from the National Kidney Foundation (NKF) web site
Yale University School of Medicine Heart Book
American Heart Association web site
American College of Cardiology web site
American Society of Hypertension web site
The Drug Monitor web site - synopsis of the essential clinical pharmacology / pharmacy information
HeartPoint - multimedia site for patient information and education
National Heart, Lung and Blood Institute web site
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  ESSENTIALS AND CLASSICS
Heart Failure Treatment from WebMD
High Blood Pressure and Kidney Disease from the NIDDK web site (in layman's terms)
Ten Facts About High Blood Pressure and Chronic Kidney Disease from the NKF web site.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure - 1997
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  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
MEDLINE PLUS for Heart Diseases Continually Updated!
heart AND dialysis Continually Updated!
hypertension AND dialysis Continually Updated!
cardiovascular disease AND end-stage renal disease AND dialysis Continually Updated!
MEDLINE / Pubmed Information from the National Library of Medicine
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  CLINICAL GUIDELINES
AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update
1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension
The National Cholesterol Education Program (NCEP) issues major new clinical practice guidelines on the prevention and management of high cholesterol in adults. The guidelines are the first major update from NCEP in nearly a decade. Press release from the NCEP. - May 15, 2001
ACC/AHA Clinical Statements / Guidelines (American College of Cardiology/American Heart Association)
Clinical Practice Guidelines for cardiovascular disease (search result) from the  National Guideline Clearinghouse web site
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  K/DOQI™ -  Kidney Disease Outcomes Quality Initiative
Clinical Practice Guidelines For Chronic Kidney Disease: Table of Contents
Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients
Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease
Managing Dyslipidemias in Chronic Kidney Disease


  DISCUSSION FORUM
General Dialysis Nursing Issues and Questions (No dedicated RenalWEB forum)
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  WEB SEARCH ENGINES
Cardiovascular Disease web sites by Yahoo! Continually Updated!
Cardiovascular Disease web sites by AOL Continually Updated!
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  INPUT / SUGGESTIONS
E-mail to RenalWEB on the Cardiovascular Disease Topic
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