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Last Updated 03/08/20

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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.

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Fibroblast Growth Factor 23: Are We Ready to Use It in Clinical Practice? - Free, Open Access, Online First article from Journal of Nephrology. - March 4, 2020

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There’s New Evidence on the Benefits of Sun Exposure - Article from Outside.   Free, full-text article from the Journal of the American Heart Association. - March 4, 2020

“In keeping with that theory, the white dialysis patients seemed to get a greater benefit from a given increase in UV exposure than the black patients, as you’d expect if dark skin pigmentation were partly blocking the beneficial UV.”

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The Eye, the Kidney & Cardiovascular Disease: Old Concepts, Better Tools & New Horizons - Free, full-text, Article in Press from Kidney International. - February 26, 2020

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Trulicity Approved to Reduce Risk of Major Adverse Cardiovascular Events - Article from Renal & Urology News. - February 26, 2020

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Intensive Blood Pressure Control Can Extend Life up to 3 Years - Press release from Brigham and Women’s Hospital. - February 26, 2020

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Blood Pressure Targets in Patients with Chronic Kidney Disease: MDRD and AASK Now Confirming SPRINT - Free, full-text, Advance Article from Clinical Kidney Journal. - February 25, 2020

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Effect of Dose and Duration of Reduction in Dietary Sodium on Blood Pressure Levels: Systematic Review and Meta-Analysis of Randomized Trials - Free, full-text article from The BMJ. - February 25, 2020

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Increased History of Ischemic Stroke and Decreased Neurocognitive Performance in Children with Chronic Kidney Disease - Online First abstract from Pediatric Nephrology. - February 24, 2020

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Pharmacologic Therapies for Aortic Stiffness in End-Stage Renal Disease: A Systematic Review and Meta-Analysis - Free, Open Access article from Canadian Journal of Kidney Health and Disease. - February 22, 2020

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Atrial Fibrillation and Associated Outcomes in Patients with Peritoneal Dialysis and Hemodialysis: a 14-Year Nationwide Population-Based Study - Online First abstract from Journal of Nephrology. - February 21, 2020

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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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
Evaluation of cardiac function in the dialysis patient—a primer for the non-expert - editorial from Nephrology Dialysis Transplantation - June 2006
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.
blue ball Medicare Preventive Services (pdf) from the Medlearn/Centers for Medicare & Medicaid Services web site
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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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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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

General Dialysis Nursing Issues and Questions (No dedicated RenalWEB forum)
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Cardiovascular Disease web sites by Yahoo! Continually Updated!
Cardiovascular Disease web sites by AOL Continually Updated!
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E-mail to RenalWEB on the Cardiovascular Disease Topic
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