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The leading cause of death for end-stage renal disease patients is cardiovascular disease (CVD).  Approximately 16,000 dialysis patients die each year (1996) from CVD 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.