Practical ways to deal with the high burden of cardiovascular disease in hemodialysis patients

Abstract

Cardiovascular disease is the main cause of death among hemodialysis patients. Although uremia by itself may be considered to be a cardiovascular risk factor, a significant proportion of dialysis patients die because of cardiovascular disease not directly attributable to uremia. Indeed, many of the cardiovascular diseases and cardiovascular risk factors in these patients are common to those occurring in the general population and are amenable to intervention. Lack of proper medical care during the early stages of renal insufficiency and present-day dialysis routines, by failing to correct hypertension, hypervolemia and left ventricular hypertrophy in many patients, may also add to the cardiovascular burden. The author suggests that, in addition to early treatment and referral to a specialist, chronic renal failure patients should undergo intensive cardiovascular screening and treatment, and correction of cardiovascular risk factors based on guidelines established for the general population.

Hemodialysis Treatment-Related Chronic Complications in Hypertensive People: Integrative Review

“…15,27 The prevalence found in this study was lower in comparison to others. As an example, a bibliographic 22 review research has found that 94% of hemodialysis patients were at high risk for LVH. This complication is a consequence of both of SAH and the overloaded volume 18,28 , which causes increased after-load and heart work.…”

Hemodialysis Treatment-Related Chronic Complications in Hypertensive People: Integrative Review

“…15,27 The prevalence found in this study was lower in comparison to others. As an example, a bibliographic 22 review research has found that 94% of hemodialysis patients were at high risk for LVH. This complication is a consequence of both of SAH and the overloaded volume 18,28 , which causes increased after-load and heart work.…”

“…advanced age, hemoglobin level and/or anemia 22 and parathyroid hormone level. 29 A study conducted with children with CKD records that anemia correction proved to be a factor able to significantly reduce the ventricular mass index in those hearts affected by LVH.…”

“…20 Other factors that might interfere with their occurrence are the presence of diabetes mellitus (DM), increased creatinine levels, hyperparathyroidism, increased homocysteine levels, oxidative stress and elevated C-reactive 21 protein plasma concentration, besides smoking habit, obesity and dyslipidemia. 22,23 Despite all this knowledge, the main This is an integrative literature review.…”

Eficácia de um protocolo de exercícios físicos em pacientes com insuficiência renal crônica, durante o tratamento de hemodiálise, avaliada pelo SF-36

“…A QVRS desses indivíduos também está diretamente ligada às complicações que eles podem vir a apresentar. Muitos autores (9,15,16,(20)(21)(22) haviam apontado para uma série de distúrbios osteomioarticulares crônicos, relacionados ao metabolismo ósseo, que o paciente portador de IRC pode vir a apresentar, alguns de particular interesse para a fisioterapia.…”