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Last Updated 12/17/17
 

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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 Pediatric Nephrology - January 2018

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Idiopathic Pre-Capillary Pulmonary Hypertension in Patients with End-Stage Kidney Disease: Effect of Endothelin Receptor Antagonists - Free, Open Access Article from Clinical and Experimental Nephrology. - December 2017

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Results of the HEMO Study Suggest That p-Cresol Sulfate and Indoxyl Sulfate Are Not Associated with Cardiovascular Outcomes - Free, Full-Text Article from Kidney International. - December 2017

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Urinary Markers of Fibrosis and Risk of Cardiovascular Events and Death in Kidney Transplant Recipients - (Registration required, but free.) Free, full-text article from American Journal of Transplantation via Medscape Nephrology. - December 15, 2017

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Free, Full-Text, New Online Viewpoint Articles from the Journal of the American Medical Association - December 14, 2017

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Red Cell Distribution Width Associated with Adverse Cardiovascular Outcomes in Patients with Chronic Kidney Disease - Free, Open Access article from BMC Nephrology. - December 13, 2017

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Abdominal Aorta and Pelvic Artery Calcifications on Plain Radiographs May Predict Mortality in Chronic Kidney Disease, Hemodialysis and Renal Transplantation - First Online abstract from International Urology and Nephrology. - December 13, 2017

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Deadly Heart Rhythm Halted by Noninvasive Radiation Therapy - December 11, 2017

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The Effect of Dialysis Type on Left Atrial Functions in Patients with End-Stage Renal Failure: A Propensity Score-Matched Analysis - Early View abstract from Echocardiography. - December 11, 2017

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Hemoglobin Concentration and the Risk of Hemorrhagic and Ischemic Stroke in Patients Undergoing Hemodialysis: the Q-Cohort Study - Advance Article abstract from NDT. - December 11, 2017

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Factors Associated with Serum Magnesium and Vascular Stiffness in Maintenance Hemodialysis Patients - Early View Abstract from Hemodialysis International. - December 11, 2017

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'Death Receptors' – New Markers for Type 2 Diabetes and Cardiovascular Disease - December 11, 2017

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Mechanisms and Mediators of Hypertension Induced by Erythropoietin and Related Molecules - Advance Article Abstract from NDT. - December 9, 2017

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Warfarin Use And the Risk Of Stroke, Bleeding, And Mortality In Older Adults On Dialysis With Incident Atrial Fibrillation - Accepted Article abstract from Nephrology. - December 8, 2017

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Angiotensin Receptor Blockers Are Associated with Lower Mortality Than ACE Inhibitors in Predialytic Stage 5 Chronic Kidney Disease: a Nationwide Study of Therapy with Renin-Angiotensin System Blockade - Free, Open Access Article from PLOS ONE. - December 7, 2017

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Evaluation of Intradialytic Hypertension Using Bioelectrical Impedance Combined With Echocardiography in Maintenance Hemodialysis Patients - Early View Abstract from Therapeutic Apheresis and Dialysis. - December 7, 2017

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Mayo Clinic Minute: Kids with High Blood Pressure - December 7, 2017

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Combined Blockade of Renin-Angiotensin-Aldosterone System Reduced All Cause but Not Cardiovascular Mortality in Dialysis Patients: a Mediation Analysis and Systematic Review - In Press abstract from Atherosclerosis. - December 6, 2017

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BP in Dialysis: Results of a Pilot Study - JASN Express abstract. - December 6, 2017

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Blood Pressure Trajectories in The 20 Years Before Death - New Online abstract and editorial extract from JAMA Internal Medicine. - December 4, 2017

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Relation of Serum ADMA, Apelin-13 and LOX-1 Levels with Inflammatory and Echocardiographic Parameters in Hemodialysis Patients - Early View Abstract from Therapeutic Apheresis and Dialysis. - December 4, 2017

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Popular Blood Pressure Medicine Linked with Increased Risk of Skin Cancer - Press release from the University of Southern Denmark Faculty of Health Sciences. - December 4, 2017

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Novel Oral Anticoagulants in Patients with Chronic Kidney Disease and Atrial Fibrillation - Advance Article abstract from NDT. - December 1, 2017

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CMS Finalizes Rule to Cancel Bundled Payment Models for Cardiac and Hip/Femur Fracture Treatments - News brief from AHANews. CMS press release. - November 30, 2017

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Heart Disease in Chronic Kidney Disease — Review of the Mechanisms and the Role of Dialysis Access - Free, full-text, Advance Online article from the Journal of Vascular Access. - November 29, 2017

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Trial Suggests Way to Personalize Heart Health in Diabetes - Press release from Joslin Diabetes Center. - November 29, 2017

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New Computer Model Sheds Light on Biological Events Leading to Sudden Cardiac Death - Press release from Johns Hopkins University. - November 28, 2017

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To Meet New Blood Pressure Guidelines, We Will Need Artificial Intelligence - Opinion piece from Healthcare DIVE. - November 27, 2017

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CANVAS: No Difference in Canagliflozin Effects by Prior CV Status - Article from Medscape Nephrology (registration required, but free). - November 27, 2017

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Coronary Calcium Helps Stratify 10-Year Cardiac Risk in Diabetes - Article from Medscape Nphrology (registration required, but free). - November 24, 2017

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Intradialytic Hypertension Is Associated with Low Intradialytic Arterial Oxygen Saturation - Free, full-text, Advance Article from NDT. - November 24, 2017

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Impact of Immunosuppressive Therapy on Arterial Stiffness in Kidney Transplantation: Are All Treatments the Same? - Free, Full-Text, Advance Articles from Clinical Kidney Journal. - November 23, 2017

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Sodium Prescription in the Prevention of Intradialytic Hypotension: New Insights into an Old Concept - Free, full-text, Issue-in-Progress in-depth review from Blood Purification. - November 23, 2017

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Low-Salt & Heart Healthy Dash Diet As Effective As Drugs for Some Adults with High Blood Pressure - Press release from Johns Hopkins Medicine. - November 22, 2017

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Prevalence of Left Ventricular Systolic Dysfunction in Pre-dialysis and Dialysis Patients with Preserved Left Ventricular Ejection Fraction - Early View abstract from European Journal of Heart Failure. - November 21, 2017

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Blood Pressure, Dietary Salt, and Genes: What Happens When the Dots Don't Connect? - Article from HealthNewsReview. - November 21, 2017

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Abdominal Aortic Calcification Score among Several Vascular Calcification Scores of Plain Radiograph Is the Most Reliable Predictor of Severe Coronary Artery Calcification in Dialysis Patients - Free, Open Access article from Renal Failure. - November 20, 2017

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Article in Press Abstracts from American Journal Of Kidney Diseases - November 20, 2017

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Cardiovascular Disease in Kidney Transplant Recipients: Japan Academic Consortium of Kidney Transplantation (JACK) Cohort Study - First Online abstract from Clinical and Experimental Nephrology. - November 20, 2017

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Free, Full-Text, New Online Articles from the Journal of the American Medical Association - November 20, 2017

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YouTube Video: New Hypertension Guidelines - (10-minute video) Duke Heart's Manesh Patel, MD and Dan Mark, MD discuss the new AHA Hypertension Guidelines. - November 20, 2017

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Under New Guidelines, 80% of Adults 65 and Older Will Qualify for High Blood Pressure - November 17, 2017

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The Relationship between Intradialytic Hypotension and Vascular Calcification in Hemodialysis Patients - Free, Open Access Article from PLOS ONE. - October 19, 2017

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Prevalence of and Predictive Factor for Abdominal Aortic Calcification in Thai Chronic Kidney Disease Patients - Free, Open Access article from Therapeutic Apheresis and Dialysis. - October 4, 2017

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Uremic Pericarditis in Patients with End Stage Renal Disease: Prevalence, Symptoms and Outcome in 2017- Articles in Press Abstract from the American Journal of Emergency Medicine. - September 5, 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
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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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new 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
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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