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Last Updated 07/15/18
 

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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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Hypertension Among Youths — United States, 2001–2016 - Article from the CDC's Morbidity and Mortality Weekly Report. - July 13, 2018

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New Guidelines Mean Almost 800,000 More U.S. Kids Have High Blood Pressure - Article from HealthDay. - July 12, 2018

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BP Monitoring in Young Adults: Is It More Than Just One Number? - Posting from the AJKD blog. - July 11, 2018

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New Guidelines Label Millions More People As Having High Blood Pressure - Press release and full-text aritcle from The BMJ. Article from Internal Medicine News. - July 11, 2018

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3 of 4 Black Americans Have High Blood Pressure by 55 - Article from HealthDay. Press release from the American Heart Association. - July 11, 2018

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At-Home, Wearable ECG Patch Helps Diagnose Atrial Fibrillation - News brief from NEJM Journal Watch. Article from HealthDay. Abstract from the Journal of the American Medical Association. - July 11, 2018

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Association Between Dialysis Modalities and Risk of Coronary Artery Disease: A Population-Based Cohort Study in Taiwan - Early View Abstract from Therapeutic Apheresis and Dialysis. - July 10, 2018

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Prevalence and Control of Hypertension by 48 Hour Ambulatory Blood Pressure Monitoring in Hemodialysis Patients: a Study by the European Cardiovascular and Renal Medicine (EURECA-m) Working Group of the ERA-EDTA - Advance Article abstract from NDT. - July 10, 2018

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Free, Full-Text, New Online Articles from the Journal of the American Medical Association - July 10, 2018

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Eicosapentaenoic Acid and Prevalence of Cardiovascular Disease in Hemodialysis Patients - Early View Abstract from Therapeutic Apheresis and Dialysis. - July 10, 2018

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Effect of Electronic Health Record–Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management — A Randomized Clinical Trial - New Online abstract from JAMA Internal Medicine. - July 9, 2018

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Hemodialysis during Cardiopulmonary Resuscitation in Patients with Severe Metabolic Acidosis - Online First abstract from The International Journal of Artificial Organs. - July 5, 2018

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Variations in 24-Hour BP Profiles in Cohorts of Patients with Kidney Disease around the World — The I-DARE Study - CJASN Express abstract. - July 5, 2018

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Impact of Hemoglobin Variability on Cardiovascular Mortality in Maintenance Hemodialysis Patients - First Online abstract from International Urology and Nephrology. - July 4, 2018

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Use of Machine-Learning Algorithms to Determine Features of Systolic Blood Pressure Variability That Predict Poor Outcomes in Hypertensive Patients - Free, full-text, Advance Article from Clinical Kidney Journal. - July 3, 2018

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Angiotensin Related Genetic Determinants of Cardiovascular Disease in Patients Undergoing Hemodialysis - Advance Article abstract from NDT. - July 2, 2018

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Plasma Cystine Levels and Cardiovascular and All-Cause Mortality in Hemodialysis Patients - Early View abstract from Therapeutic Apheresis and Dialysis. - July 2, 2018

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Having Hypertension during Pregnancy May Affect Cardiovascular Health for Life - Press releases from American College of Physicians and Brigham and Women's Hospital. Latest Article abstract, editorial extract, and full-text Summary for Patients from Annals of Internal Medicine. Article from HealthDay. - July 2, 2018

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Assessment of Peritoneal Membrane Arteriolar Structure in Conjunction with Traditional Cardiovascular System Evaluation in Chronic Kidney Disease (CKD) Stage 5 Patients - Free, Open Access, Issue-In-Progress Article from Kidney & Blood Pressure Research. - June 2018

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Hypertension Canada 2018 Update - Posting from the AJKD blog. - June 29, 2018

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For Dialysis Patients with AFib, a Newer Blood Thinner May Provide a Safer Option - Press release from the University of Michigan. - June 28, 2018

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Spuriously Low Serum Bicarbonate Levels in Patients With Hyperlipidemia: A Report of 4 Cases - Article in Press abstract from American Journal of Kidney Diseases. - June 28, 2018

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Risk Factors for Increased Left Ventricular Hypertrophy in Patients with Chronic Kidney Disease: Findings from the CKD-JAC Study - Free, Open Access, First Online article from Clinical and Experimental Nephrology. - June 27, 2018

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In Women, Even Mild Sleep Problems May Raise Blood Pressure - June 26, 2018

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New Study Links Poor Sleep Quality to Atrial Fibrillation - June 26, 2018

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Clinical Value of Ambulatory Blood Pressure in Pediatric Patients after Renal Transplantation - Free, Open Access article from Pediatric Nephrology. - June 25, 2018

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Subjective Global Assessment-Dialysis Malnutrition Score and Cardiovascular Risk in Hemodialysis Patients: an Observational Cohort Study - First Online abstract from Journal of Nephrology. - June 23, 2018

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Patients with End-Stage Renal Disease Have Poor Outcomes after Endovascular Abdominal Aortic Aneurysm Repair - Article in Press abstract from Journal of Vascular Surgery. - June 23, 2018

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Free, Full-Text, Advance Articles from Clinical Kidney Journal - June 21, 2018

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Renal Denervation: the Story So Far... - Posting from the Nephrology Journal Club blog. - June 21, 2018

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Uremic Pruritus is Associated with Two-Year Cardiovascular Mortality in Long himTerm Hemodialysis Patients - Free, Open Access, Issue-in-Progress article from Kidney & Blood Pressure Research. - June 15, 2018

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End Stage Renal Disease Patients Using Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers May Reduce the Risk of Mortality: A Taiwanese Nationwide Cohort Study - Accepted Article abstract from Internal Medicine Journal. - May 29, 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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