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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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Published Ahead of Print CJASN Abstract/Extracts - January 2019

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Blood Pressure Variability, Mortality, and Cardiovascular Outcomes in Chronic Kidney Disease Patients - Published Ahead of Print CJASN abstract. - January 2019

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Researchers Discover How to Treat Diastolic Heart Failure - Press release from the University of Minnesota Medical School. - January 10, 2019

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Cardiovascular Outcomes in African Americans with Sickle Cell Trait and Chronic Kidney Disease - Online First Abstract from American Journal Of Nephrology. - January 9, 2019

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Canadian Nephrologist Views Regarding Stroke and Systemic Embolism Prevention in Dialysis Patients With Nonvalvular Atrial Fibrillation: A Survey - Free, Open Access article from Canadian Journal of Kidney Health and Disease. - January 8, 2019

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An Analysis of the Impact of Fluid Overload and Fluid Depletion for All Cause and Cardiovascular Mortality - Advance Article abstract from NDT. - January 8, 2019

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Beyond Pharmacotherapy: Lifestyle Counseling Guidance Needed for Hypertension - Latest Article abstract from Annals of Internal Medicine. - January 8, 2019

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The Apple Watch 4 Is an Iffy Atrial Fibrillation Detector in Those under Age 55 - Article from STAT. - January 8, 2019

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The Impact of Antihypertensive Pharmacotherapy on Interplay between Protein-Bound Uremic Toxin (Indoxyl Sulfate) and Markers of Inflammation in Patients with Chronic Kidney Disease - Free, Open Access, First Online article from International Urology and Nephrology. - January 7, 2019

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Cardiovascular Event Risk Higher With Total Parathyroidectomy - Article from Renal & Urology News. - January 7, 2019

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Parathyroidectomy for SHPT Reduces Aortic Calcification - Article from Renal & Urology News. - January 4, 2019

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Effect of Bicarbonate-Buffered Dialysate on Ventricular Arrhythmias in Hemodialysis Patients - Online First abstract from American Journal of Nephrology. - January 2, 2019

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Moderate Alcohol Intake Linked to Longer Survival in Heart Failure - News brief from NEJM Journal Watch. - January 2, 2019

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Coenzyme Q10 Supplementation on Metabolic Profiles of Patients with Chronic Kidney Disease - Press release from Current Pharmaceutical Design. - December 27, 2018

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Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blo ckers, ß-Blockers or Both in Incident End-Stage Renal Disease Patients without Cardiovascular Disease: a Propensity-Matched Longitudinal Cohort Study - Advance Articles Abstract from NDT. - December 24, 2018

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Intradialytic Exercise Preconditioning: an Exploratory Study on the Effect on Myocardial Stunning - Advance Article abstract from NDT. - December 22, 2018

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Two Type 2 Diabetes Drugs Linked to Higher Risk of Heart Disease - Press release from Northwestern University. - December 21, 2018

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Myocardial Remodeling after Kidney Transplantation: a Case Report - Free, Open Access article from BMC Nephrology. - December 20, 2018

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World's First Blood Pressure Smart Watch from Omron - Article from MedGadget. - December 20, 2018

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Diabetes Drug Could Be Used to Treat Common Heart Failure Syndrome, Study Suggests - Press release from the Rockefeller University Press. - December 19, 2018

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Effects of Liraglutide Versus Placebo on Cardiovascular Events in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease — Results From the LEADER Trial - Abstract from Circulation. - December 18, 2018

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Take High Blood Pressure Meds? Exercise Might Work Just As Well - Article from HealthDay. - December 18, 2018

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Barbershop BP Intervention Going Strong at 12 Months - Article from Internal Medicine News. - December 17, 2018

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The Association of Echocardiographic Peak Systolic Strain Rate with Cardiovascular Outcomes in Haemodialysis Patients - Free, Full-Text, Online First Article from Kidney and Blood Pressure Research. - December 14, 2018

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Low Copeptin Levels in Patients with Intradialytic Hypotension - Accepted Article abstract from Therapeutic Apheresis and Dialysis. - December 14, 2018

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
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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.
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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