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Last Updated 03/12/17
 

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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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Free, Full-Text Articles from American Journal Of Kidney Diseases - March 2017

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Why Do We Develop High Blood Pressure? - Press release from the Physiological Society. - March 9, 2017

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Sex Differences in Vascular Dysfunction and Cardiovascular Outcomes: the Cardiac, Endothelial Function, and Arterial Stiffness in ESRD (CERES) Study - Early View Abstract from Hemodialysis International. - March 8, 2017

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Longitudinal Assessment of Myocardial Function in Childhood Chronic Kidney Disease, during Dialysis, and Following Kidney Transplantation - First Online abstract from Pediatric Nephrology. - March 8, 2017

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Press Releases from the American College of Cardiology - March 8, 2017

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Relationship between Hypotension and Cerebral Ischemia during Hemodialysis - JASN Express Abstract. - March 7, 2017

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High Number of Deaths from Heart Disease, Stroke and Diabetes Linked to Diet - Press release from NIH/National Heart, Lung and Blood Institute. Article from HealthDay. - March 7, 2017

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Hypophosphatemia: Nutritional Status, Body Composition, and Mortality in Hemodialysis Patients - First Online abstract from International Urology and Nephrology. - March 6, 2017

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Blood Pressure Management in Hemodialysis Patients: What We Know And What Questions Remain - Early View Abstract from Seminars In Dialysis. - March 6, 2017

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Many People Don't Take Their High Blood Pressure Meds: Study - Article from HealthDay. - March 6, 2017

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Frequency of Early Predialysis Nephrology Care and Postdialysis Cardiovascular Events - Article in Press abstract from American Journal of Kidney Diseases. - March 3, 2017

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Applying the Systolic Blood Pressure Intervention Trial Results to Older Adults - (Registration required, but free.) Free, full-text article from Journal of the American Geriatrics Society via Medscape Nephrology. - March 3, 2017

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Abdominal Aortic Calcification on a Plain X-Ray and the Relation with Significant Coronary Artery Disease in Asymptomatic Chronic Dialysis Patients - Free, Open Access article from BMC Nephrology. - March 2, 2017

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Decreasing Sudden Deaths in Dialysis: Drugs, Devices, or Dialytic Developments? - Posting from the AJKD blog. - March 1, 2017

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Chlorthalidone Versus Amlodipine for Hypertension in Kidney Transplant Recipients Treated With Tacrolimus: A Randomized Crossover Trial - Articles in Press Abstract from American Journal of Kidney Diseases. - March 1, 2017

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Exercise Beats Weight Loss at Helping Seniors' Hearts - March 1, 2017

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Free, Open Access Articles from Journal of Nephrology - February 2017

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Higher Dietary Potassium to Sodium Ratio Can Lower CVD Risk - February 28, 2017

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Relationship between History of Coronary Heart Disease at Dialysis Initiation and Onset of Events Associated with Heart Disease: a Propensity Matched Analysis of a Prospective Cohort Study - Free, Open Access Article from BMC Nephrology. - February 28, 2017

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Association of Triiodothyronine Levels with Left Ventricular Function, Cardiovascular Events, and Mortality in Hemodialysis Patients - Advance Online abstract from the International Journal of Artificial Organs. - February 28, 2017

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Cardiovascular Disease in Hemodialysis: Role of the Intravascular Innate Immune System- Advance Online Abstract from Nature Reviews Nephrology. - February 27, 2017

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Inactivity, Excess Weight Linked to Hard to Treat Heart Failures - Press release from UT Southwestern Medical Center. Article from HealthDay. - February 27, 2017

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Aortic Stenosis in Dialysis Patients- Early View Abstract from Seminars in Dialysis. - February 26, 2017

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Effects of Cardiac Function with Postoperative Arteriovenous Fistula Blood Flow in Patients with Hemodialysis - Issue-in-Progress Abstract from Blood Purification. - February 25, 2017

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Awesome HTN Trial Cheat Sheet and Info for Becoming an ASH Specialist in Clinical Hypertension - February 25, 2017

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Heart Function and Structure during the First Year of Hemodialysis Treatment: Cardiac Uraemic Fibrosis Detection in Dialysis Patients, an Observational Prospective Study - Abstract from The Lancet. - February 23, 2017

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Venous Hemodialysis Catheters and Cardiac Implantable Electronic Devices: Avoiding a High-Risk Combination - Early View abstract from Seminars in Dialysis. - February 23, 2017

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Blood Pressure Targets in Older Patients: Many Guidelines, Much Confusion - (Registration required, but free.) Interview from Medscape Nephrology. - February 21, 2017

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Testosterone Treatment Improves Bone Density and Anemia, May Lead to Cardiac Risk - Press releases from the University of Pennsylvania School of Medicine, Yale University and the JAMA Network Journals. Article from HealthDay. Free, full-text articles from JAMA and Online First articles from JAMA Internal Medicine. - February 21, 2017

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Raising Dietary Potassium to Sodium Ratio Helps Reduce Heart, Kidney Disease - February 21, 2017

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3,000 Steps in 30 Minutes Improves the Prognosis for Heart Failure - February 21, 2017

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JASN Express Abstracts - February 20, 2017

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Steep BP Drop Using 'Quadpill' in Untreated HTN: Pilot Study - (Registration required, but free.) Article from Medscape Nephrology. - February 20, 2017

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The Impact of Renal Protection Clinics on Prescription of and Adherence to Cardioprotective Drug Therapy in Chronic Kidney Disease Patients - Free, Full-Text, Advance Access Article from Clinical Kidney Journal. - February 18, 2017

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Sudden Cardiac Death Among Hemodialysis Patients - Article in Press abstract from American Journal of Kidney Diseases. - February 17, 2017

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Limiting Salt Consumption Lowers Blood Pressure in Patients with Kidney Disease - February 16, 2017

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Factors Associated with Reduction of Left Ventricular Mass in Children On Peritoneal Dialysis - Accepted Article abstract from Nephrology. - February 15, 2017

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Abnormal Ankle Brachial Index and Risk of Cardiovascular or All-Cause Mortality in Patients with Chronic Kidney Disease: a Meta-Analysis - First Online abstract from Journal of Nephrology. - February 15, 2017

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Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients - Free, Open Access Article from PLOS ONE. - February 14, 2017

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Cardiovascular Disease Costs Will Exceed $1 Trillion by 2035 - February 14, 2017

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Cardiac Troponins in Chronic Kidney Disease: A Marker of Global Cardiovascular Risk - Free, full-text, Issue-in-Progress editorial and related abstract from American Journal of Nephrology. - February 14, 2017

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Association of Serum Triglyceride to HDL Cholesterol Ratio with All-Cause and Cardiovascular Mortality in Incident Hemodialysis Patients - CJASN Express abstract. - February 13, 2017

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Researchers Find Clues to Why Diet with Olive Oil Is Tied Lower Heart Disease Risk - February 13, 2017

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'Antiaging' Hormone Could Unlock New Treatments for Kidney and Heart Disease - February 12, 2017

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Hypertension in Chronic Kidney Disease after the Systolic Blood Pressure Intervention Trial: Targets, Treatment and Current Uncertainties - Advance Access Abstract from NDT. - February 11, 2017

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Reducing Cardiovascular Mortality in Kidney Disease: Time to Focus on Heart Failure? - (Registration required, but free.) Article from Medscape Nephrology. - February 10, 2017

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Cardiothoracic Ratio and All-Cause Mortality and Cardiovascular Disease Events in Hemodialysis Patients: The Q-Cohort Study - Articles in Press Abstract from American Journal of Kidney Diseases. - February 10, 2017

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Intensive Blood Pressure Control Could Prevent 100,000 U.S. Deaths Each Year - February 9, 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
ACCF/AHA Guideline for Management of Heart Failure: 2013 Update (click on PDF link in the right column for full report)
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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