RenalWEB Outcomes - Cardiovascular

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Last Updated 6/16/19

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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

	Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial - Abstract and editorial extract from Journal of the American College of Cardiology. - June 2019
	Blood Pressure and Incident Atrial Fibrillation in Older Patients Initiating Hemodialysis - Published Ahead of Print CJASN Abstract. - June 2019
	Lipids, Apolipoproteins, and Risk of Atherosclerotic Cardiovascular Disease in Persons With CKD - Free, Full-Text Articles from American Journal Of Kidney Diseases. - June 2019
	Free, Full-Text Articles from Kidney International - June 2019 The Effect of Dry-Weight Reduction Guided by Lung Ultrasound on Ambulatory Blood Pressure in Hemodialysis Patients: a Randomized Controlled Trial Heart Failure in Chronic Kidney Disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
	Relationship between History of Ischemic Stroke and All-Cause Mortality in Incident Dialysis Patients - Free, Open Access, Online First article from Nephron. - June 11, 2019
	*APOL1* and Mortality in Patients on Dialysis - Free, full-text, Online First editorial from CardioRenal Medicine. - June 11, 2019
	Soluble Klotho Is Associated with Mortality and Cardiovascular Events in Hemodialysis - Free, Open Access Article from BMC Nephrology. - June 11, 2019
	The Predictive Value of Klotho Polymorphism, in Addition to Classical Markers of CKD-MBD, for Left Ventricular Hypertrophy in Hemodialysis Patients - First Online abstract from International Urology and Nephrology. - June 11, 2019
	Impact of Age on Cardiovascular Drug Use in Patients with Chronic Kidney Disease - Free, full-text, Advance Article from Clinical Kidney Journal. - June 10, 2019
	Patients Whose Blood Pressure Only Spikes at the Doctor's Office Are Twice As Likely to Die of a Heart Attack or Other Cardiac Event - Article from STAT. - June 10, 2019
	Dulaglutide Cuts Cardiovascular Risk in Type 2 Diabetes - Posting from NEJM Journal Watch. Press release from McMaster University. - June 10, 2019
	Intraoperative Arterial Biopsy in Incident Hemodialysis Patients: Differences Observed - Online First abstract from Nephron. - June 6, 2019
	AHA News: Diabetes and Heart Failure Are Linked; Treatment Should Be Too - Article from HealthDay. - June 6, 2019
	Tight Diabetes Control Alone May Not Benefit the Heart Long-Term - Article and physician's briefing from HealthDay. - June 5, 2019
	Prophylactic Use of Implantable Cardioverter-Defibrillators in the Prevention of Sudden Cardiac Death in Dialysis Patients — The Prospective, Randomized, Controlled ICD2 Trial - Published Ahead of Print abstract from Circulation. Article from Medscape Nephrology (registration required). - June 4, 2019
	Sleepless Nights Linked to High Blood Pressure - Press release from University of Arizona. - June 4, 2019
	'Pumping Heart Patch' Ready for Human Use - Article from the BBC. - June 4, 2019
	Kidney Inflammation and Hypertension - Posting from the Renal Fellow Network blog. - June 3, 2019
	Diagnosis of High Blood Pressure Is Declining Among Adults With Chronic Kidney Disease - Topic from the CDC's Chronic Kidney Disease Surveillance System. - May 2019
	Association of Gait Speed and Grip Strength with Risk of Cardiovascular Events in Patients on Hemodialysis: a Prospective Study - Free, Open Access article from BMC Nephrology. - May 30, 2019
	Comparative Effectiveness of Different Antihypertensive Agents in Kidney Transplantation: a Systematic Review and Meta-Analysis - Advance Article abstract from NDT. - May 29, 2019
	Energy Drinks Prolong QTc Interval, Elevate Blood Pressure - Article from HealthDay. - May 29, 2019
	A Balancing Act: Managing Acute Stroke in Patients on Hemodialysis - Posting from the Renal Fellow Network blog. - May 28, 2019
	Free, Open Access Articles from BMC Nephrology - May 28, 2019 Coronary Calcification As a Predictor of Cardiovascular Mortality in Advanced Chronic Kidney Disease: a Prospective Long-Term Follow-Up Study Factors Associated with Adverse Outcomes from Cardiovascular Events in the Kidney Transplant Population: an Analysis of National Discharge Data, Hospital Characteristics, and Process Measure
	Free, Full-Text, Online First Articles from American Journal of Nephrology - May 24, 2019 The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis Editorial: Redefining the Burden of Intradialytic Hypotension in the Modern Era of Hemodialysis
	Blood Pressure and Glucose Control May Prevent Common Arrhythmia - Press release from UCSF. - May 24, 2019
	PDI in Press Abstracts - May 23, 2019 Free Water Transport and Its Association with Cardiovascular Status in Children on Peritoneal Dialysis Residual Renal Function and Effect of Low-Sodium Solution on Blood Pressure in Peritoneal Dialysis Patient
	A Comprehensive Review on Apolipoproteins As Nontraditional Cardiovascular Risk Factors in End-Stage Renal Disease: Current Evidence and Perspectives - Online First Abstract from International Urology And Nephrology. - May 22, 2019
	Hypertension Found in Children Exposed to Flower Pesticides - Press release from University of California San Diego. - May 22, 2019
	A Systematic Review and Meta-analysis of Non-pharmacologic-based Interventions for Aortic Stiffness in ESRD - Free, Full-Text, Articles in Press from Kidney International Reports. - May 21, 2019
	Parathyroidectomy Ups Cardiovascular Risks in Dialysis Patients - Article from Renal & Urology News. - May 21, 2019
	Annals Consult Guys - Cardiovascular Risk, Blood Pressure, and Cognition in a Patient With Diabetes - 16-minute video from Annals of Internal Medicine. - May 21, 2019
	The New Marker YKL-40, a Molecule Related to Inflammation, Is Associated with Cardiovascular Events in Stable Hemodialysis Patients - Free, Full-Text, Advance Articles from Clinical Kidney Journal. - May 20, 2019
	Comparison between Clinical Judgment and Integrated Lung and Inferior Vena Cava Ultrasonography for Dry Weight Estimation in Hemodialysis Patients - Early View abstract from Hemodialysis International. - May 20, 2019
	News Releases 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
	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
	Division for Heart Disease and Stroke Prevention: Interactive Atlas from the Centers for Disease Control and Prevention (CDC) web site
	Free, Full-Text, New Online Articles from the Journal of the American Medical Association - November 20, 2017 Clinical Guidelines Synopsis — Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults Editorial: The New 2017 ACC/AHA Guidelines "Up the Pressure" on Diagnosis and Treatment of Hypertension Viewpoint Article: The 2017 Clinical Practice Guideline for High Blood Pressure
	High Blood Pressure and Kidney Disease: How Are They Connected? from the Kidney & Urology Foundation of America (KUFA) web site
	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.
	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
	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
	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

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KDIGO™ - Kidney Disease Improving Global Outcomes ( pronounced "kay de go" )

Kidney Disease Improving Global Outcomes (KDIGO) web site

Clinical Practice Guideline for Lipids in CKD (Published 2013)
Clinical Practice Guideline for Blood Pressure in CKD (Published 2012)

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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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