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Last Updated 06/18/17
 

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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 NDT - June 2017

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

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Warfarin and the Risk of Stroke and Bleeding in Patients With Atrial Fibrillation Receiving Dialysis: A Systematic Review and Meta-analysis - Abstract from Canadian Journal of Cardiology. - June 2017

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Abstracts from Nephron - June 2017

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Vascular Calcification and Osteoprotegrin in Chronic Kidney Disease - Free, full-text, Issue-in-Progress editorial and related abstract from American Journal of Nephrology. - June 15, 2017

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Study of Cardiovascular Outcomes in Renal Transplantation: A Prospective, Multicenter Study to Determine the Incidence of Cardiovascular Events in Renal Transplant Recipients in Ontario, Canada - Free, Open Access article from Canadian Journal of Kidney Health and Disease. - June 14, 2017

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Articles in Press Abstracts from American Journal Of Kidney Diseases - June 13, 2017

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Treating to Target in Older Hypertensive Patients: Where Is the Bull's Eye? - Free, full-text, Article in Press from American Journal of Kidney Diseases. - June 13, 2017

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Role of Vascular Calcification Inhibitors in Preventing Vascular Dysfunction and Mortality in Hemodialysis Patients - Early View Abstract from Seminars In Dialysis. - June 13, 2017

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Cardiac Arrest? Someday, Drones May Come to Your Rescue - Article from HealthDay. - June 13, 2017

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Free, Full-Text, Online First Articles from the New England Journal Of Medicine - June 12, 2017

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Blood Pressure Management in Children on Dialysis - First Online abstract from Pediatric Nephrology. - June 9, 2017

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Home Blood Pressure Monitors Inaccurate 70% of the Time: Study - June 7, 2017

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Smaller Dose Combos of Blood Pressure Meds May Be Effective with Fewer Side Effects - June 5, 2017

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Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality, or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of the FAVORIT Trial Cohort - Articles in Press Abstract from American Journal of Kidney Diseases. - June 2, 2017

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Association of Intensive Blood Pressure Control and Kidney Disease Progression in Nondiabetic Patients With Chronic Kidney Disease — A Systematic Review and Meta-analysis - Abstract from JAMA Internal Medicine. - June 1, 2017

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CJASN Express Abstracts - May 2017

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Severe Hyperkalemia Complicating Parathyroidectomy in Patients with End-Stage Renal Disease - Abstract from Anaesthesia and Intensive Care. - May 2017

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Articles from Renal & Urology News - May 31, 2017

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Study Suggests Lower Targets for Systolic Blood Pressure - Press release from Tulane University. Article from MedPage Today (registration required, but free). Free, full-text, New Online article from JAMA Cardiology. - May 31, 2017

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Modern Peptide Biomarkers and Echocardiography in Cardiac Healthy Hemodialysis Patients - Free, Open Access Article from BMC Nephrology. - May 30, 2017

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Apixaban Use in Dialysis Patients: A Need to Rethink Dosing - Article from Pharmacy Times. - May 30, 2017

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Modification of Potassium-Mortality Relationship by Ethnicity and Race: Solving the Puzzle - Free, full-text, Issue-in-Progress editorial from American Journal of Nephrology. - May 30, 2017

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Effects of Orthostatism and Hemodialysis on Mean Heart Period and Fractal Heart Rate Properties of Chronic Renal Failure Patients - Early View Abstract from Artificial Organs. - May 26, 2017

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`Medicare to Cover Supervised Exercise for Heart Disease - Decision memo from CMS. Article from Modern Healthcare (registration required, but free). - May 25, 2017

Editor's note: One can only hope that the American Society of Nephrology or the Renal Physicians Association will someday embrace some form — any form — of renal rehabilitation for their dialysis patients.

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One in 3 High Blood Pressure Patients Failing to Take Medication - May 25, 2017

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Long-Term Assessment of the Safety and Efficacy of PA21 (Sucroferric Oxyhydroxide) in Japanese Hemodialysis Patients With Hyperphosphatemia: An Open-Label, Multicenter, Phase III Study - Free, full-text, Article in Press from Journal of Renal Nutrition. - May 24, 2017

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Sleepless Nights Could Pose Heart Risk Dangers - May 24, 2017

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Antithrombotic Therapy in End-Stage Renal Disease - Early View abstract from Hemodialysis International. - May 23, 2017

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Intensive Blood Pressure (Lowering) Can Reduce Risk of Harm to Heart Muscle - Press release from Wake Forest Baptist Medical Center. Published Ahead of Print abstract from Circulation. - May 22, 2017

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Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults — The ALLHAT-LLT Randomized Clinical Trial - Free, full-text, New Online article and editor's note from JAMA Internal Medicine. - May 22, 2017

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Racial and Ethnic Differences in Mortality Associated with Serum Potassium in a Large Hemodialysis Cohort - Issue-in-Progress abstract from American Journal of Nephrology. - May 20, 2017

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Patiromer for Hyperkalemia Recommended for Marketing in EU - May 19, 2017

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Early and Asymptomatic Cardiac Dysfunction in Chronic Kidney Disease - Advance Article abstract from NDT. - May 19, 2017

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Redefining Blood Pressure Targets - Free, full-text article from European Heart Journal. - April 6, 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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