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Last Updated 09/10/17
 

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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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Treating to Target in Older Hypertensive Patients: Where Is the Bull's Eye? - Free, Full-Text Article from American Journal of Kidney Diseases. - September 2017

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Free, Open Access Articles from BMC Nephrology - September 7, 2017

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SPRINT: Caution on Aggressive BP Reduction in Certain Groups - (Registration required, but free.) Article from Medscape Nephrology. - September 7, 2017

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Temple Researchers Help Uncover Mechanism behind Heart Failure and Mortality in Sepsis - September 7, 2017

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Prevalence of Earlobe Creases and Their Association With History of Cardiovascular Disease in Patients Undergoing Hemodialysis: A Cross-Sectional Study - Early View Abstract from Therapeutic Apheresis and Dialysis. - September 7, 2017

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Kidney Disease Is Linked to Higher Risk for Atrial Fibrillation - (Registration required, but free.) Commentary from Medscape Nephrology. - September 6, 2017

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Many Older Adults With A-Fib Do Not Receive Anticoagulants - Article from Renal & Urology News. - September 6, 2017

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Association Between More Intensive vs Less Intensive Blood Pressure Lowering and Risk of Mortality in Chronic Kidney Disease Stages 3 to 5 — A Systematic Review and Meta-analysis - New Online abstract and editorial extract from JAMA Internal Medicine. - September 5, 2017

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Effects of Intensive Systolic Blood Pressure Control on Kidney and Cardiovascular Outcomes in Persons Without Kidney Disease: A Secondary Analysis of a Randomized Trial - Latest Article abstract from Annals of Internal Medicine. - September 5, 2017

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Progression of Arterial Stiffness Is Associated with Changes in Bone Mineral Markers in Advanced CKD - Free, Open Access Article from BMC Nephrology. - September 4, 2017

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Diabetes and Heart Disease Linked by Genes, Reveals Penn-Led Study - September 4, 2017

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Association of Serum Potassium with All-Cause Mortality in Patients with and without Heart Failure, Chronic Kidney Disease, and/or Diabetes - Free, Open Access, Issue-in-Progress article from American Journal of Nephrology. - September 2, 2017

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Medical Students Fall Short on Blood Pressure Check Challenge - Free, full-text, New Online article from The Journal of the American Medical Association. - August 30, 2017

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Articles from Medscape Nephrology (registration required, but free) - August 30, 2017

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Variation in Sodium Intake and Intra-Individual Change in Blood Pressure in Chronic Kidney Disease - Article in Press abstract from Journal of Renal Nutrition. - August 30, 2017

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Reverse Epidemiology of Elevated Blood Pressure among Chronic Hemodialysis Black Patients with Stroke: a Historical Cohort Study - Free, Open Access article from BMC Nephrology. - August 30, 2017

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Cardiac Arrests in Black Neighborhoods Less Likely to get CPR, Defibrillation - Press release from Duke Health. - August 30, 2017

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Pooled Analysis of Phase III Trials Indicate Contrasting Influences of Renal Function on Blood Pressure, Body Weight, and HbA1c Reductions with Empagliflozin - Article in Press abstract from Kidney International. - August 30, 2017

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SPYRAL HTN-OFF MED: Reopens Renal-Denervation Conversation - (Registration required, but free.) Article from Medscape Nephrology. - August 29, 2017

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Renal Denervation Using Carbon Dioxide Renal Angiography in Patients with Uncontrolled Hypertension and Moderate to Severe Chronic Kidney Disease - Free, full-text, Advance Article from Clinical Kidney Journal. - August 29, 2017

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Renal Denervation Lowers Blood Pressure in Hypertensive Patients - Press release from European Society of Cardiology. - August 28, 2017

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Young Adults May Be Ignoring High Blood Pressure - August 28, 2017

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Married Patients with Heart Disease Have Better Survival Rates - August 28, 2017

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High Salt Intake Associated with Doubled Risk of Heart Failure - Press release from the European Society of Cardiology. - August 27, 2017

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A First: Drug Lowers Heart Risks by Curbing Inflammation - AP article. Free, full-text, Online First article from The New England Journal of Medicine. - August 27, 2017

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Researchers Find Combination Therapy Works Best for Heart Diseases - August 27, 2017

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When Two Is Better Than Three: Dual Antithrombotic Therapy Cuts Bleeding Risk - August 27, 2017

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Catheter Ablation Better Than Traditional Drug Therapies for Treating Atrial Fibrillation - August 27, 2017

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Undiagnosed Heart Condition 'AFib' May Be Common - August 26, 2017

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Impact of Trajectories of Abdominal Aortic Calcification over 2 Years on Subsequent Mortality: a 10-Year Longitudinal Study - Advance Article abstract from NDT. - August 25, 2017

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Could Your Mouthwash Be Putting You at Risk for High Blood Pressure? - August 25, 2017

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Two Studies Support Intensive Blood Pressure Control for Long-Term Health, Quality of Life - Press release from University of Utah Health. Article abstract and special article abstract from The New England Journal of Medicine. Article from HealthDay. - August 23, 2017

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APOL1 Risk Variants Independently Associated with Early Cardiovascular Disease Death - 25-page pdf - Article in Press Abstract and Full-Text PDF from Kidney International Reports. - August 22, 2017

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Low-Income Patients More Likely to Take Blood Pressure Medication When Doctor Involves Them in Conversation - August 22, 2017

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How Text Messaging Could Help Tackle High Blood Pressure in at-Risk Patients - August 22, 2017

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Lower Blood Pressure Best for Seniors' Minds - Article from HealthDay. Free, full-text, New Online article from JAMA Neurology. Article from MedPage Today (registration required, but free). - August 21, 2017

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Kids' Cases of High Blood Pressure May Rise under New Guidelines - Article from HealthDay. Press release from the American Academy of Pediatrics. - August 21, 2017

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Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged =18 Years — Los Angeles County, 1999–2006 and 2007–2014 - Article from the CDC's Morbidity and Mortality Weekly Report. - August 18, 2017

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Heart Failure and CKD: Learning with Nephrologists - Article from Medscape Nephrology (registration required, but free). - August 17, 2017

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Association of Left Ventricular Systolic Dysfunction with Mortality in Incident Peritoneal Dialysis Patients - Accepted Article abstract from Nephrology. - August 16, 2017

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Levocarnitine Decreases Intradialytic Hypotension Episodes: A Randomized Controlled Trial - Early View abstract from Therapeutic Apheresis and Dialysis. - August 14, 2017

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Factors Associated with Cardiovascular Target Organ Damage in Children after Renal Transplantation - First Online abstract from Pediatric Nephrology. - August 13, 2017

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Researchers Explore a Better Way to Measure Blood Pressure - August 9, 2017

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Death Rate for People with Heart Disease and Depression Double Than for Non-Depressed Heart Patients - Press release from Intermountain Medical Center. - July 27, 2017

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
The Guide to Medicare Preventive Services (pdf) from the Medlearn/Centers for Medicare & Medicaid Services web site
Division for Heart Disease and Stroke Prevention: Interactive Atlas from the Centers for Disease Control and Prevention (CDC) web site
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.
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
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
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
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 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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