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Cardiovascular Disease in ESRD Patients

By Susan Eymann, MS23 Sep 2019

(Gleaned from the 2018 USRDS Annual Data Report: Volume II: Chapter 8)

Patients with end-stage renal disease (ESRD) are among the highest risk populations for cardiovascular diseases (CVDs)—a major cause of death in ESRD patients. The kidney news-2relationship between kidney disease and acute myocardial infarction (AMI), coronary artery disease (CAD), heart failure (HF), and sudden death/cardiac arrhythmias is complex and bi-directional. ESRD often complicates disease management of CVD, influencing both medical and procedural options, thereby adversely affecting a patient’s prognosis.

  • Cardiovascular disease is common in adult end-stage renal disease (ESRD) patients, with coronary artery disease the most common condition, exceeding 50% in HD patients age 65 and older.
  • Heart failure is also common in ESRD patients.
  • Older ESRD patients have a higher prevalence of cardiovascular conditions than younger patients, whether they were receiving HD or PD.
  • Even relatively young ESRD patients—those ages 22-44 and 45-64 —are likely to suffer from cardiovascular disease.
  • Cardiovascular diseases increase short- and long-term mortality for ESRD patients.
  • Only about two-thirds of dialysis or transplant patients with acute myocardial infarction (AMI) received beta-blocker medication. Similarly, among ESRD patients with heart failure, fewer than half received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Although many ESRD patients with atrial fibrillation (AF) are at elevated risk of stroke, only about one-third of dialysis patients with AF were treated with warfarin.
  • Peritoneal dialysis patients had a lower burden of certain cardiovascular conditions, including coronary artery disease, heart failure, and peripheral artery disease, as compared to their HD counterparts.
    Non-invasive cardiac function assessment