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Last Updated 01/22/12
 

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The leading cause of death for end-stage renal disease patients is cardiovascular disease (CVD).  In the prevalent dialysis population, the percentage of deaths due to cardiac disease has fallen from 45 in 1997–1999 to 39 in 2007–2009; the percentage attributable to cardiovascular disease has declined from 50 to 42 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

Abstracts from Atherosclerosis - February 2012
Effects of Thrice Weekly Nocturnal Hemodialysis on Arterial Stiffness
Oxidized High-Density Lipoprotein As a Risk Factor for Cardiovascular Events in Prevalent Hemodialysis Patients
Study on the Relationship between Serum 25 Hydroxyvitamin D Levels and Vascular Calcification in Hemodialysis Patients with Consideration of Seasonal Variation in Vitamin D Levels

Lipid-Lowering Therapy in Individuals With CKD: Lessons Learned From SHARP - Free, Full-Text Article from American Journal Of Kidney Diseases - February 2012

Issue in Progress Abstracts from Blood Purification - January 20, 2012
Sudden Cardiac Death in Hemodialysis Patients: A Comprehensive Care Approach to Reduce Risk
Hypertension and Future Cardiovascular Health in Pediatric End-Stage Renal Disease Patients

Regression of Left Ventricular Mass Following Conversion from Conventional Hemodialysis to Thrice Weekly in-Center Nocturnal Hemodialysis - Provisional abstract and full-text article (25-page PDF) from BMC Nephrology. - January 19, 2012

"High-Normal" Blood Pressure Linked to Atrial Fibrillation - . Abstract from Hypertension. - January 17, 2012

Altitude and the Risk of Cardiovascular Events in Incident US Dialysis Patients - Advance Access Abstract from NDT - January 17, 2012

Bisphosphonate Therapy, Death, and Cardiovascular Events Among Female Patients With CKD: A Retrospective Cohort Study - Article in Press abstract from American Journal of Kidney Diseases. - January 16, 2012

Effects of Lowering Dialysate Sodium on Carotid Artery Atherosclerosis and Endothelial Dysfunction in Maintenance Hemodialysis Patients - Online First Abstract from International Urology and Nephrology - January 14, 2012

CJASN Express Abstracts - January 2012
Mortality in Kidney Disease Patients Treated with Phosphate Binders: A Randomized Study
Relationship between CRP Polymorphism and Cardiovascular Events in Chinese Peritoneal Dialysis Patients

Decreased Paraoxonase One (PON One) Lactonase Activity in Hemodialyzed and Renal Transplanted Patients. A Novel Cardiovascular Biomarker in End-Stage Renal Disease - Advance Access abstract from NDT. - January 12, 2012

Red Wine-Heart Research Slammed with Fraud Charges - Article from Reuters.. - January 12, 2012

Articles in Press Abstracts from Journal of Nephrology - January 11, 2012
Establishing Goals of Volume Management in Critically Ill Patients with Renal Failure
Risk Factors Associated with Increased Left Ventricular Mass Index in Chronic Kidney Disease Patients Evaluated Using Echocardiography

Altered Relative Concentrations of High-Energy Phosphates in Patients with Uremic Cardiomyopathy Measured by Magnetic Resonance Spectroscopy - Advance Access Abstract from NDT - January 11, 2012

Prognostic Value of Arterial Pulse Wave Velocity in Peritoneal Dialysis Patients - Issue in Progress abstract from American Journal of Nephrology. - January 11, 2012

Too Much Vitamin D Could Be Harmful to Heart - Article from HealthDay. - January 10, 2012

Blood Pressure Components and End-stage Renal Disease in Persons With Chronic Kidney Disease: The Kidney Early Evaluation Program (KEEP) - Abstract from Archives of Internal Medicine. - January 9, 2012

Statins Increase Diabetes Risk in Older Women - Articles from MedPage Today and HealthDay. - January 9, 2012

Nation’s Leading Medical Organizations of Physicians Support Use of Central Blood Pressure Assessment in Effort to Improve Hypertension Care in Patients - January 9, 2012

Persistently Low Intact Parathyroid Hormone Levels Predict a Progression of Aortic Arch Calcification in Incident Hemodialysis Patients - Online First abstract from Clinical and Experimental Nephrology. - January 5, 2012

Increased Gout Risk With Diuretic Use Confirmed - Article from MedPage Today. - January 5, 2012

Blood Pressure Stability in Hemodialysis Patients Confers a Survival Advantage: Results from a Large Retrospective Cohort Study - Advance Online abstract from Kidney International. - January 4, 2012

(Volume Status) Is the Glass Half Empty or Half Full? - Posing from Renal Fellow Network. - January 4, 2012

Benefits of Statin Therapy May Extend beyond Lowering Lipids - January 4, 2012

Company Claims Optical Blood Pressure Monitor Breakthrough - January 3, 2012

When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis? - Issue-in-Progress Abstract from Kidney & Blood Pressure Research - January 3, 2012

Articles in Press abstracts from American Journal of Kidney Diseases - December 30, 2011
Utilization and Costs of Cardiovascular Disease Medications in Dialysis Patients in Medicare Part D
Predictive Models for Acute Kidney Injury Following Cardiac Surgery
Factors Associated With Intradialytic Systolic Blood Pressure Variability

BioTrends ChartTrends® Report: New Study of Chronic Kidney Disease Patients Finds That Treatment with Phosphate Binders and Active Vitamin D is Significantly Higher When Nephrologists Suspect Arterial Calcification - December 28, 2011

Doubt Cast on Use of Genetic Test Before Plavix - December 28, 2011

Improved CVD Risk Prediction Model in Diabetes Identified - Article from HealthDay. - December 27, 2011

New Blood Test May Rule Out Heart Attacks More QuicklyNew Blood Test May Rule Out Heart Attacks More Quickly - December 27, 2011

FDA Okays BP Drug Combo - December 23, 2011

Prolactin Levels, Endothelial Dysfunction, and the Risk of Cardiovascular Events and Mortality in Patients with CKD - CJASN Express Abstracts - December 2011

Advance Online Abstracts from Kidney International - December 21, 2011
Renal Outcomes in Hypertensive Black Patients at High Cardiovascular Risk
The Prevalence of and Factors Associated with Chronic Atrial Fibrillation in Medicare/Medicaid Eligible Dialysis Patients

Early View Abstracts from Artificial Organs - December 21, 2011
An Experimental, Simplified Method for Intradialytic Cardiac Output Measurement
Visual Three-Dimensional Representation of Beat-to-Beat Electrocardiogram Traces During Hemodiafiltration

Effects of Short- and Long-Term Hypercholesterolemia on Contrast-Induced Acute Kidney Injury - Issue-in-Progress Abstract from American Journal of Nephrology - December 21, 2011

Home Systolic Blood Pressure on the Morning of Dialysis Days Has Prognostic Impact for Hypertensive Hemodialysis Patients - Online First abstract from Clinical and Experimental Nephrology. - December 20, 2011

Plasma Concentration of von Willebrand Factor Predicts Mortality in Patients on Chronic Renal Replacement Therapy - Advance Access Abstract from NDT - December 20, 2011

Treating High Blood Pressure May Add Years to Life - Article from HealthDay. News release and abstract from JAMA. - December 20, 2011

Increase in Resting Heart Rate over 10-Year Period Linked with Increased Risk of Heart Disease Death - December 20, 2011

Novartis Ends Study of Hypertension Drug in High Risk Heart and Kidney Patients - December 20, 2011

Nutritional Vitamin D Supplementation in Hemodialysis: a Potential Vascular Benefit? - Accepted article abstract from Nephrology. - December 19, 2011

Prevalence of Atrial Fibrillation and Warfarin Use in Older Patients Receiving Hemodialysis - Article in Press abstract from Journal of Nephrology. - December 16, 2011

Achievements in CKD-MBD Guidelines Targets: Is There a Progress in the Implementation Practice? - Online First abstract from International Urology and Nephrology. - December 16, 2011

Hemodialysis and the Risk of Stroke: a Population-based Cohort Study in Taiwan, a Country of High Incidence of End-Stage Renal Disease - Accepted Article Abstract from Nephrology - December 15, 2011

Relationship between Magnesium and Clinical Biomarkers on Inhibition of Vascular Calcification - Issue in Progress abstract from American Journal of Nephrology. - December 15, 2011

Contrast-Free MRI Identifies Cardiac Ischemia - Article from MedPage Today. - December 13, 2011

Prevalence and Prognosis of Unrecognized Myocardial Infarctions in Chronic Kidney Disease - Advance Access Abstract from NDT: - December 13, 2011

Statins Accelerate Depletion of Plaque in Arteries - Press release from the New York University School of Medicine. - December 13, 2011

Prevalence and Clinical Significance of Heparin-Induced Antibodies in Chronic Hemodialysis Patients and Cardiac Surgery Patients - Article in Press Abstract from The International Journal of Artificial Organs - December 12, 2011

Evaluation of Advanced Glycation End Products Accumulation, Using Skin Autofluorescence, in CKD and Dialysis Patients - Online First abstract from International Urology and Nephrology. - December 10, 2011

High Plasma Pentosidine Level Is Accompanied with Cardiovascular Events in Hemodialysis Patients - Online First abstract from Clinical and Experimental Nephrology. - December 9, 2011

News Releases 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 calculators - subject page from RenalWEB
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.
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
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
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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