Cardiac disease in chronic uremia: Management

J. Venkatesan, William L Henrich

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Heart disease is a common cause of morbidity and mortality in end-stage renal disease (ESRD) patients. The management of heart disease in these patients requires a multidimensional approach to the management of heart failure, coronary disease, and arrhythmias, and to risk factors such as hypertension, anemia, secondary hyperparathyroidism, and electrolyte/acid- base disturbances. Coronary artery disease management includes use of antianginal drugs and revascularization of coronary arteries with angioplasty ± stent placement or coronary artery bypass grafting. The long-term outcomes of these procedures need to be assessed and improved. Hypertension occupies a major role in the pathogenesis of heart disease in ESRD, and early and adequate control of hypertension is likely to have a major impact on the progression of cardiac disease. This entails the achievement of optimal volume status, combined with the appropriate use of antihypertensive agents such as calcium channel blockers, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, vasodilators, alpha-blockers, and central sympatholytic drugs. In ESRD patients, specific dialysis-related complications such as intradialytic hypotension and pericardial effusion may have additional effects on cardiac function and require attention. The choice of dialysate composition and membrane may influence clinical outcomes with specific effects on cardiac performance.

Original languageEnglish (US)
Pages (from-to)249-266
Number of pages18
JournalAdvances in Renal Replacement Therapy
Volume4
Issue number3
StatePublished - 1997
Externally publishedYes

Fingerprint

Uremia
Heart Diseases
Chronic Kidney Failure
Hypertension
Sympatholytics
Secondary Hyperparathyroidism
Pericardial Effusion
Dialysis Solutions
Calcium Channel Blockers
Disease Management
Vasodilator Agents
Angioplasty
Angiotensin-Converting Enzyme Inhibitors
Coronary Artery Bypass
Hypotension
Antihypertensive Agents
Electrolytes
Stents
Coronary Disease
Cardiac Arrhythmias

Keywords

  • Arrhythmias
  • Coronary artery disease
  • Drug therapy
  • Heart failure
  • Hypertension
  • Management

ASJC Scopus subject areas

  • Nephrology

Cite this

Cardiac disease in chronic uremia : Management. / Venkatesan, J.; Henrich, William L.

In: Advances in Renal Replacement Therapy, Vol. 4, No. 3, 1997, p. 249-266.

Research output: Contribution to journalArticle

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