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Last Updated 2/21/10
 

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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.

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
Factors Predicting Mortality in Elderly Patients on Dialysis - Issue-in-Progress abstract from Nephron Clinical Practice. - February 19, 2010
Median Intradialytic Blood Pressure Can Track Changes Evoked by Probing Dry-Weight - CJASN Express abstract. - February 18, 2010
Happiness Makes for a Healthy Heart - Article from Reuters. - February 18, 2010
Kidney and Brain—a Renal Perspective of ‘Les Liaisons Dangereuses’ - Free, full-text, Advance Access editorial commentary from NDT. - February 17, 2010
Many Patients May Never Fill New Prescriptions for Diabetes and Hypertension - Article from Reuters. - February 17, 2010
Diabetes Risk of Statins Outweighed by Heart Benefit - Article from Medpage Today. - February 17, 2010
High Levels of Vitamin D in Older People Can Reduce Heart Disease and Diabetes - Article from Warwick Medical School. - February 15, 2010
Low Levels of Natural Antibodies Behind Stroke - Article from the Karolinska Institutet. - February 12, 2010
Study Finds New Stent Improves Ability To Keep Vessels Open for Dialysis Patients - Press release from the University of Maryland Medical Center and abstract from The New England Journal of Medicine (NEJM) . Extract of NEJM editorial. - February 10, 2010
Circulating Monocyte Subpopulations with High Expression of Angiotensin-Converting Enzyme Predict Mortality in ESRD Patients - Advance Access abstract from NDT. - February 10, 2010
Cardiac Science Automated External Defibrillators (Powerheart, Cardiovive, CardioLife models): Recall - Safety information from FDA. - February 9, 2010
FDA Okays Statin for Primary Prevention of Cardiovascular Disease - Article from MedPage Today. - February 8, 2010
Research Warns of Risks of Low Potassium in Heart Failure Patients with CKD - Press release from the University of Alabama at Birmingham. - February 8, 2010
Using Vertebral Bone Densitometry To Determine Aortic Calcification in Patients with Chronic Kidney Disease - Abstract of accepted article from Nephrology. - February 5, 2010
Cardiovascular Effects of Angiotensin Converting Enzyme Inhibition or Angiotensin Receptor Blockade in Hemodialysis: A Meta-Analysis - CJASN Express abstract. - February 4, 2010
Higher Systolic Blood Pressure Is Associated with Progression of Carotid Intima–Media Thickness in Patients with CKD - Advance online abstract from Kidney International. - February 3, 2010
As Use of Herbal Remedies Soars, Patients Taking These and Cardiovascular Medications May be at Heightened Risk of Dangerous, Potentially Life-Threatening Interactions - Article from the Mayo Clinic. - February 1, 2010
Blood Pressure in CKD Stage 5D—Report from a Kidney Disease: Improving Global Outcomes Controversies Conference - Free, full-text, meeting report from Kidney International. - February 1, 2010
Pediatrics: Blood Pressure Target for Renoprotection in Children - Free, full-text article from Nature Reviews Nephrology. - February 2010
Statin Prescription is Essential in Peripheral Vascular Disease - Free, full-text CME article from the Journal of Vascular and Interventional Radiology. - February 2010
Echocardiography in Chronic Kidney Disease: Diagnostic and Prognostic Implications - Free, full-text, Issue-in-Progress minireview from Nephron Clinical Practice. - February 2010
AURORA: Is There a Role for Statin Therapy in Dialysis Patients? - Free, full-text article from AJKD. - February 2010
Effects of Dialysis Purity on Uremic Dyslipidemia - Free, full-text article from Therapeutic Apheresis and Dialysis. - January 2010
Guidelines Needed To Improve Care for Patients with MI, Chronic Kidney Disease - Report from Cardiology Today. - January 28, 2010
Study Design and Subject Baseline Characteristics in the ADVANCE Study: Effects of Cinacalcet on Vascular Calcification in Hemodialysis Patients - Advance Access abstract from NDT. - January 27, 2010
Magnesium in Chronic Kidney Disease: Challenges and Opportunities - (13-page pdf) Free, full-text, minireview from Blood Purification. - January 26, 2010
Perioperative Outcomes Among ESRD Patients Following Coronary Artery Bypass Surgery in US - Advance Access abstract from NDT. - January 26, 2010
More High Blood Pressure Worries: It's Linked to Dementia - Article from AP. - January 26, 2010
Soluble Fas: a useful marker of inflammation and cardiovascular diseases in uremic patients - Abstract from Clinical and Experimental Nephrology. - January 25, 2010
Low-carb Diet Effective at Lowering Blood Pressure - Release from Duke University Medical Center. - January 25, 2010
Albuminuria and Heart Disease Linked Only in White Diabetics - Article from Renal and Urology News. - January 22, 2010
Home-based vs. Center-based Cardiac Rehabilitation: Cochrane Systematic Review and Meta-Analysis - Free, full-text article from British Medical Journal. - January 19, 2010
Lower Afib Risk Seen with Some Antihypertensives More than Others - Article from Medpage Today. - January 19, 2010
Blood Pressure and Mortality Among Hemodialysis Patients - Abstract from Hypertension. - January 18, 2010
Sodium Thiosulfate Delays the Progression of Coronary Artery Calcification in Hemodialysis Patients - Advance Access abstract from NDT. - January 18, 2010
The Role of Vitamin D Receptors and Activators in Cardiovascular and Kidney Health - 8-page pdf from KDIGO. - January 15, 2010
Increased Left Ventricular Mass in Chronic Kidney Disease and End-Stage Renal Disease: What Are the Implications? - Full-text article from Dialysis & Transplantation. - January 14, 2010
Myocardial Fibrosis and Diastolic Dysfunction in Patients on Chronic Hemodialysis - Advance Access abstract from NDT. - January 14, 2010
News Releases from the American Heart Association  Continually Updated!
Newsworthy Events and New Features - from the American Heart Association Continually Updated!
Latest Cardiovascular Disease News Stories - Yahoo! News Continually Updated!
Latest Hypertension News Stories - Yahoo! News Continually Updated!
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  WEB RESOURCES
Latest Scientific Journal Articles on Cardiovascular Disease - list compiled by RenalWEB's Journal Watch
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 in ESRD: Special Study Center from the United States Renal Data Center (USRDS). USRDS Cardiovascular Presentations and Posters.
Cardiovascular disease calculators - subject page from RenalWEB
Cardiovascular Disease in Children with CKD or ESRD - Free, full-text article from Nature Reviews Nephrology. - April 2009
Cardiovascular complications of pediatric chronic kidney disease - educational feature from Pediatric Nephrology - February 2008
Cause or Casualty? The Impact and Role of the Kidney on Inflammation, Metabolic Syndrome and Atherogenesis (pdf) free CE program from the National Kidney Foundation (NKF) web site
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
High Blood Pressure and Kidney Disease: How Are They Connected? web cast from the Kidney & Urology Foundation of America (KUFA) web site
Hypertension Review CEU activity from the Kidney Learning System web site
National Cholesterol Education Program (NCEP) web site. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
Webcast CME: Cardiovascular Disease in CKD from Doctor's Guide
The Well-Controlled Patient: Looking Beyond the Lab Tests from the National Kidney Foundation (NKF) web site
Yale University School of Medicine Heart Book
American Heart Association web site
American College of Cardiology web site
American Society of Hypertension web site
The Drug Monitor web site - synopsis of the essential clinical pharmacology / pharmacy information
HeartPoint - multimedia site for patient information and education
National Heart, Lung and Blood Institute web site
The Transonic Flow-QC Hemodialysis Monitor Also Measures Cardiac Output (an optional capability) 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)
Ten Facts About High Blood Pressure and Chronic Kidney Disease from the NKF web site.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure - 1997
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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
1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension
The National Cholesterol Education Program (NCEP) issues major new clinical practice guidelines on the prevention and management of high cholesterol in adults. The guidelines are the first major update from NCEP in nearly a decade. Press release from the NCEP. - May 15, 2001
ACC/AHA Clinical Statements / Guidelines (American College of Cardiology/American Heart Association)
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 on Hypertension and Antihypertensive Agents in Chronic Kidney Disease
Managing Dyslipidemias in Chronic Kidney Disease


  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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