The Clinical and Epidemiological Aspects of Vascular Mortality in Chronic Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 80-83 ◽  
Author(s):  
Philip Kam-Tao Li ◽  
Kai Ming Chow
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Ventricular Hypertrophy ◽  
Residual Renal Function ◽  
Left Ventricular ◽  
Clinical Aspects ◽  
Published Data ◽  
Dialysis Patients ◽  
Reverse Epidemiology ◽  
Vascular Mortality

This article reviews the clinical aspects of and epidemiological links between vascular mortality and the dialysis population, and emphasizes areas that warrant further clarification. In particular, we highlight potential pitfalls in interpretation of published observational and clinical studies, notably some of the issues related to reverse epidemiology of risk factors for cardiovascular disease. Recent published data from our own center in the Prince of Wales Hospital relating to the significance of residual renal function, inflammation, valvular calcification, as well as left ventricular hypertrophy were highlighted. Actions are needed to tackle both the traditional and the nontraditional factors for cardiovascular disease in order to treat this problem causing the highest mortality in peritoneal dialysis patients.

Continuous Ambulatory Peritoneal Dialysis in High-Risk Patients: Patients with Cardiovascular Diseases -Role of the Nurse

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 499-503
Author(s):  
Marie-Christine Z. Lambert ◽  
Holger Schilling
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Ventricular Hypertrophy ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Therapeutic Success ◽  
Risk Patients ◽  
Continuous Peritoneal Dialysis ◽  
Artery Disease

Most patients receiving renal replacement therapy have cardiovascular disease. The most frequent conditions are left ventricular hypertrophy and coronary artery disease. Hemodialysis is associated with a characteristic spectrum of acute complications (such as hypotension, sudden death) that can be explained by typical dialysis -induced effects on the heart. With continuous peritoneal dialysis (CAPO) some of the cardiovascular complications are ameliorated owing to slow ultrafiltration and absence of an arteriovenous fistula. CAPO might be concluded to be the preferable option in patients with cardiovascular disease, but a few disadvantages, such as hyperlipidemia and hyperinsulinemia, also exist. Nurses also play an important role in the therapeutic success and outcomes of these patients.

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

2006 ◽  
Vol 124 (1) ◽  
pp. 36-41 ◽  
Author(s):  
José Jayme Galvão de Lima
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Ventricular Hypertrophy ◽  
Significant Proportion ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Dialysis Patients

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.

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