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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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BPA Replacement Hinders Heart Function, Study Reveals - Press release from University of Guelph. - January 9, 2020

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How Do Outcomes for In-Hospital Cardiac Arrest Differ in Patients Treated with Dialysis? - Press release, Published Ahead of Print CJASN abstract and editorial extract from the American Society of Nephrology. Article from HealthDay. - January 7, 2020

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New Hypertension Performance Measures Boost 130/80 mm Hg Target - Article from Internal Medicine News. - January 6, 2020

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Preservation of Renal Function in Cardiac Surgery Patients With Low Cardiac Output Syndrome — Levosimendan vs Beta Agonists - (Registration required, but free.) Article from BMC Anesthesiology via Medscape Nephrology. - December 30, 2019

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Role of Direct Oral Anticoagulants in Patients with Kidney Disease - Article in Press abstract from Kidney International. - December 24, 2019

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Peripheral Artery Disease: Its Adverse Consequences With and Without CKD - Article in Press abstract from American Journal of Kidney Diseases. - December 24, 2019

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Uric Acid and Left Ventricular Hypertrophy: Another Relationship in Hemodialysis Patients - Free, Full-Text Advance Articles from Clinical Kidney Journal. - December 22, 2019

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Prognostic Values of Left Ventricular Mass Index in Chronic Kidney Disease Patients - Advance Articles Abstract from NDT. - December 20, 2019

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Effect of Intradialytic Exercise on Physical Performance and Cardiovascular Risk Factors in Patients Receiving Maintenance Hemodialysis: A Pilot and Feasibility Study - Online First Abstract from Blood Purification. - December 19, 2019

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Blood Pressure Measurement: A KDOQI Perspective - Free, Full-Text Articles in Press from American Journal of Kidney Diseases. - December 18, 2019

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Emergence of Chloride as an Overlooked Cardiorenal Connector in Heart Failure - Free, Full-Text, Online First Article from Blood Purification. - December 18, 2019

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Blood Pressure Measurement: A KDOQI Perspective - Free, Full-Text, Articles in Press from American Journal of Kidney Diseases - December 18, 2019

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Taking Blood Pressure Measurement Properly is Vital to Patients' Health - Press release from the National Kidney Foundation. - December 18, 2019

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Blood Pressure Measurement: A KDOQI Perspective - Article in Press abstract from American Journal of Kidney Diseases. - December 18, 2019

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Cardiac Stunning during Hemodialysis: the Therapeutic Effect of Intra-Dialytic Exercise - Free, Full-Text, Advance Articles from Clinical Kidney Journal. - December 17, 2019

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Long-Term All-Cause Mortality and Cardiovascular Outcomes in Scottish Children after Initiation of Renal Replacement Therapy: a National Cohort Study - Free, Full-Text, Online First Article from Pediatric Nephrology. - December 16, 2019

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
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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  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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