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Last Updated 4/21/19
 

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The leading cause of death for end-stage renal disease patients is cardiovascular disease (CVD).  According to the United States Renal Data System (USRDS) one uniform finding is the progressively increased representation for each cardiovascular
condition with respect to advanced CKD stage and age. In the non-CKD population, for example, only 3.6 percent of patients age 66–69 have congestive heart failure (CHF), compared to 15 percent of those age 85 and older. Among patients with Stage 4–5 CKD, these numbers reach 34 and 48 percent. CHF is a common comorbid condition in elderly patients, particularly among those with advanced CKD. 2012

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
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Mortality Outcomes With Intensive Blood Pressure Targets in Chronic Kidney Disease Patients - Online First abstract from Hypertension. - April 2019

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Serum Metabolites and Cardiac Death in Patients on Hemodialysis - Published Ahead of Print CJASN Article. - April 2019

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Free, Full-Text Articles from American Journal of Kidney Diseases - April 2019

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A Randomized Controlled Trial of the Effect of Spironolactone on Left Ventricular Mass in Hemodialysis Patients - Free, Full-Text Article from Kidney International. - April 2019

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Mount Sinai Researchers Discover That Diabetes Drug May Reverse Heart Failure - Press release from Mount Sinai School of Medicine. - April 18, 2019

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Cardiovascular Benefits of a Diet Enriched in Fruits and Vegetables - Free, full-text, Online First editorial and related abstract from American Journal of Nephrology. - April 17, 2019

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Key Updates in Cardio-Nephrology from 2018: Springboard to a Bright Future - Free, full-text, Online First editorial from CardioRenal Medicine. - April 17, 2019

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Online First Abstracts from CardioRenal Medicine - April 17, 2019

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Cardiovascular Disease in the Kidney Transplant Recipient: Epidemiology, Diagnosis and Management Strategies - Advance Article abstract from NDT. - April 15, 2019

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Normalizing BP in Elderly With Hypertension May Up Mortality - Article from HealthDay. - April 15, 2019

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Clinicians, CMS Confer over Heart Failure-Readmission Penalty - Article from Internal Medicine News. - April 10, 2019

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Magnesium but Not Nicotinamide Prevents Vascular Calcification in Experimental Uremia - Free, Full-Text, Advance Articles from NDT. - April 9, 2019

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CMS Proposes Expanding Coverage of Ambulatory Blood Pressure Monitoring (ABPM) - CMS press release. - April 9, 2019

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Articles from Medscape Nephrology (registration required, but free) - April 8-9, 2019

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Epicardial Fat, Cardiovascular Risk Factors and Calcifications in Patients with Chronic Kidney Disease - Free, full-text, Advance Article from Clinical Kidney Journal. - April 8, 2019

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NephMadness 2019 Champion: US Hypertension Guideline - Posting from the AJKD blog. Related tweet. - April 8, 2019

Editor's note: NephMadness needs to be introduced to a concept called renal rehabilitation. . They can't keep excluding what's most important to patients — to live as normal lives as possible. It's time to stop the widespread debilitation of dialysis patients.

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Association between the Cardio-Ankle Vascular Index and Diabetes Mellitus-Related Peripheral Arterial Disease in Chronic Hemodialysis Patients - Free, Open Access, Online First Article from Blood Purification. - April 3, 2019

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Online First Abstracts from Blood Purification - April 3, 2019

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The Paradox of Hypertonic Saline Use in Heart Failure - Posting from the Renal Fellow Network blog. - April 3, 2019

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Blood Pressure Control, Acute Kidney Injury, and Cardiovascular Events: Separating the Chaff from the Wheat - Free, full-text, Online First editorial and related abstract from American Journal of Nephrology. - April 2, 2019

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Indoxyl Sulfate and p-Cresyl Sulfate Promote Vascular Calcification and Associate with Glucose Intolerance - Published Ahead of Print JASN abstract. - April 2, 2019

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Association of Mineral Content Outside of Bone with Coronary Artery Calcium and 1-Year Cardiovascular Prognosis in Maintenance Hemodialysis Patients - Accepted Article abstract from Artificial Organs. - April 1, 2019

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Renal Denervation Reduced BP in Sham-Controlled Trials, Meta-Analysis Shows - Article from Internal Medicine News. - April 1, 2019

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Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes - Published Ahead of Print CJASN Abstract. - March 2019

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Comparative Cardiac Safety of Selective Serotonin Reuptake Inhibitors among Individuals Receiving Maintenance Hemodialysis - Published Ahead of Print JASN abstract and editorial extract. - March 2019

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Serum Calcification Propensity and Coronary Artery Calcification Among Patients With CKD: The CRIC (Chronic Renal Insufficiency Cohort) Study - Article in Press abstract from American Journal of Kidney Diseases. - March 29, 2019

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Body Composition and Arterial Stiffness in Pediatric Patients with Chronic Kidney Disease - First Online abstract from Pediatric Nephrology. - March 29, 2019

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Cardiovascular Event Rates among Haemodialysis Patients across Geographical Regions-a Snapshot from DOPPS - Free, full-text, Article in Press from Kidney International Reports. - March 27, 2019

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Systolic Blood Pressure Intervention Trial and Statins, a Story of Statistical Interaction - Free, full-text, Online First editorial and related abstract from American Journal of Nephrology. - March 27, 2019

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Comparison of 24-hour and Office Pulse Wave Velocity for Prediction of Mortality in Hemodialysis Patients - Online First abstract from American Journal of Nephrology. - March 27, 2019

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Omron Wins FDA Nod for Combined Blood Pressure Monitor, EKG - Article from MassDevice. - March 25, 2019

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Cardiovascular Adaptations Associated with Exercise in Patients on Hemodialysis - Early View Abstract from Seminars In Dialysis. - March 24, 2019

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Association of Post-Discharge Specialty Outpatient Visits with Readmissions and Mortality in High-Risk Heart Failure Patients - Abstract from American Heart Journal. - March 21, 2019

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Fibroblast Growth Factor 23 in Chronic Kidney Disease: What Is Its Role in Cardiovascular Disease? - Free, full-text, Advance Article from NDT. - March 21, 2019

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Risk of Cardiovascular Disease and Mortality in Young Adults With End-stage Renal Disease—An Analysis of the US Renal Data System - Free, full-text, Online First article from JAMA Cardiology. - March 20, 2019

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Dietary Fiber Intake, Myocardial Injury and Major Adverse Cardiovascular Events among End-Stage Kidney Disease Patients: A Prospective Cohort Study - Free, Full-Text, Articles in Press from Kidney International Reports. - March 20, 2019

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Oral Candida Colonization As A Risk Factor For Chronic Inflammation and Atherosclerosis in Hemodialysis Patients - Acceptable Article abstract from Therapeutic Apheresis and Dialysis. - March 20, 2019

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Prophylactic Use of Implantable Cardioverter-Defibrillators in the Prevention of Sudden Cardiac Death in Dialysis Patients: The Prospective Randomized Controlled ICD2 Trial - Ahead of Print abstract from Circulation. - March 18, 2019

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New Guidelines Back off Aspirin for Primary Cardiovascular Prevention - News brief from the NEJM Journal Watch. - March 18, 2019

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Apple Touts Results from Massive AF-Detection Apple Watch Study - Articles from MassDevice and STAT. - March 16, 2019

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Should You Get Pills or Surgery for A-Fib? - Article from HealthDay. The papers were published March 15 in the Journal of the American Medical Association. - March 15, 2019

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Mother and Child Reunion in "Hypertensive" End-Stage Renal Disease: Will They Complement Each Other? - Free, Open Access, Online First article from Nephron. - March 14, 2019

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Bempedoic Acid Lowers LDL Levels - News brief from NEJM Journal Watch. - March 14, 2019

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Most Important Prognostic Values to Predict Major Adverse Cardiovascular, Cerebrovascular, and Renal Events in Patients with Chronic Kidney Disease Including Hemodialysis for 2 Years - Abstract from Cardiology. - March 13, 2019

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Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration with Arterial Calcification and Stiffness in Incident Hemodialysis Patients - Free, Open Access, Article in Press from Kidney International Reports. - March 13, 2019

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Hypertension Hot Potato — Anatomy of the Angiotensin-Receptor Blocker Recalls - Free, full-text, Recently Published perspective piece from the New England Journal of Medicine. - March 13, 2019

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Joint Association of Urinary Sodium and Potassium Excretion with Cardiovascular Events and Mortality: Prospective Cohort Study - Article from The BMJ. - March 13, 2019

"This study concludes that the J-shaped association of sodium intake with mortality and cardiovascular events does not lend support to the current WHO recommendation to consume low sodium diets"

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New Generic Blood Pressure Drug Is Approved to Relieve Shortages - FDA news release. - March 12, 2019

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Cost-Effectiveness of Lipid Lowering with Statins and Ezetimibe in Chronic Kidney Disease - Free, Full-Text, Articles in Press from Kidney International. - March 11, 2019

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Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association - Ahead of Print abstract and full-text article (39-page pdf) from Circulation. Posting from the NephronPower blog. Related tweet. - March 11, 2019

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Blood Pressure Control Is Beneficial, Is It Not? - Press release from Charité - Universitätsmedizin Berlin. - March 11, 2019

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Newer Antihyperglycemic Drugs Have Distinctive CV, Kidney Benefits - Article from Internal Medicine News. - March 7, 2019

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Grading of Left Ventricular Diastolic Dysfunction with Preserved Systolic Function by the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging Recommendations Contributes to Predicting Cardiovascular Events in Hemodialysis Patients - Online First abstract from CardioRenal Medicine. - March 7, 2019

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Metformin Use and Cardiovascular Events in Patients with Type 2 Diabetes and Chronic Kidney Disease - Free, full-text, Early View article from Diabetes, Obesity and Metabolism. - January 22, 2019

blue ball News Releases from the American Heart Association  Continually Updated!
blue ball Latest Cardiovascular Disease News Stories - Yahoo! News Continually Updated!
blue ball Latest Hypertension News Stories - Yahoo! News Continually Updated!
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  WEB RESOURCES
blue ball Latest Scientific Journal Articles on Cardiovascular Disease
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 calculator and related abstract from BMJ - July 2001
Cardiovascular complications of pediatric chronic kidney disease - educational feature from Pediatric Nephrology - February 2008
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
Division for Heart Disease and Stroke Prevention: Interactive Atlas from the Centers for Disease Control and Prevention (CDC) web site
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Free, Full-Text, New Online Articles from the Journal of the American Medical Association - November 20, 2017

High Blood Pressure and Kidney Disease: How Are They Connected? from the Kidney & Urology Foundation of America (KUFA) web site
blue ball Hypertension - this is a growing library of key high-impact articles in nephrology, chosen by UKidney's contributors as suggested reading for nephrology trainees and practitioners.
blue ball Medicare Preventive Services (pdf) from the Medlearn/Centers for Medicare & Medicaid Services web site
National Cholesterol Education Program (NCEP) (pdf) from the NIH web site. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
Smoothie Recipe Book for Renal and Heart Health by Victoria L Hulett JD (Author), Jennifer L Waybright RN (Contributor)
Understanding Cardiac Biomarkers in ESRD: Frequently Asked Questions and the Promise of Clinical Application - free, full-text review (43-page pdf) from Nephrology. - October 15, 2010
American Heart Association web site
American College of Cardiology web site
American Society of Hypertension web site
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Cardio Renal Society of America - web site Twitter #CardioRenal

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)
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure - 2003
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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
2003 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension
blue ball Management of Heart Failure in Advancing CKD: Core Curriculum 2018 from the American Journal of Kidney Diseases
Treatment of Anemia in Patients With Heart Disease: A Clinical Practice Guideline From the American College of Physicians article from the Annals of Internal Medicine - December 2013
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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 for Hypertension and Antihypertensive Agents in Chronic Kidney Disease
Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease


KDIGO™ -  Kidney Disease Improving Global Outcomes ( pronounced "kay de go" )

Kidney Disease Improving Global Outcomes (KDIGO) web site


  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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