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Diabetic Renal-Retinal Syndrome pp 129–145Cite as

Prevention, Diagnosis and Management of Heart Disease in Patients with Renal Failure

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Abstract

Cardiovascular disease (CVD) is the leading cause of death in patients with end stage renal disease (ESRD), accounting for approximately 50% of all deaths in uremic patients [1]–[4]. According to the USRDS, approximately 16,000 patients on dialysis die each year from CVD [5]. This represents an overall CVD mortality of approximately 9% annually, which is about 30 times greater than that in the general population [5], [10]. The increased cardiovascular risk in patients with end-stage renal disease (ESRD) is due to a multiplicity of factors, including an excess burden of traditional risk factors as well as abnormalities associated with the chronic renal failure itself. In particular, an aging population of patients with ESRD, and high prevalences of diabetes and hypertension (the two most common causes of ESRD in the US [5], [11]), are powerful risk factors for cardiovascular morbidity and mortality. However, even after adjustment for these and other factors (gender, etc.), cardiovascular mortality rates remain considerably higher among patients with renal failure than in the general population. Importantly, the burden of CVD is increased in both those with ESRD and in those not yet requiring renal replacement therapy [6]–[9].

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References

  1. Baigent C, Burbury K, Wheeler D. Premature cardiovascular disease in chronic renal failure. Lancet 2000; 356: 147–152.

    Article  PubMed  CAS  Google Scholar 

  2. Levin A, Foley RN. Cardiovascular disease in chronic renal insufficiency. Am J Kidney Dis 2000; 36(Suppl 3): S24–S30.

    Article  PubMed  CAS  Google Scholar 

  3. Vaitkus PT. Current status of prevention, diagnosis, and management of coronary artery disease in patients with kidney failure. Am Heart J 2000; 139: 1000–1008.

    Article  PubMed  CAS  Google Scholar 

  4. Herzog CA. Acute myocardial infarction in patients with end-stage renal disease. Kidney International 1999; 56(Suppl 71): S130–S133.

    Article  Google Scholar 

  5. USRDS US Renal Data System 2000. Annual Data Report. The National Institues of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Bethesda, MD.

    Google Scholar 

  6. Shulman N, et al. Prognostic value of serum creatinine... HDFP. Hypertension 1989; 13: I80–I93.

    Article  PubMed  CAS  Google Scholar 

  7. Flack J, et al. MRFIT. Am J Kid Dis 1993; 21: 31–40.

    PubMed  CAS  Google Scholar 

  8. Mann JFE, et al. Renal insufficiency as a predictor of cardiovascular outcomes … HOPE. Ann Intern Med 2001 (April); 134: 629–636.

    PubMed  CAS  Google Scholar 

  9. Hall WD. Kidney CVD. Am J Med Sci 1999; 317: 176–182.

    Article  PubMed  CAS  Google Scholar 

  10. Levey AS, Beto JA, Coronado BE, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease. Executive Summary. Report from the National Kidney Foundation Task Force on Cardiovascular Disease, October 1998. National Kidney Foundation document. Am J Kidney Dis 1998; 32(Suppl 2): S5–S13.

    Article  PubMed  CAS  Google Scholar 

  11. Gomez-Farices MA, McClellan W, Soucie JM. A prospective comparison of methods for determining if cardiovascular disease is a predictor of mortality in dialysis patients. Am J Kidney Dis 1994; 23: 382.

    Google Scholar 

  12. Wingard DL, Barrett-Connor E. Heart Disease and Diabetes. In: Harris M (ed), Diabetes in America. 2nd ed. National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases. NIH Publication No. 95-1468, 1995, pp 429–445.

    Google Scholar 

  13. Kunz K, Dimitrov Y, Muller S, Chantrel F, Hannedouche T. Uremic cardiomyopathy. Nephrol Dial Transplant 1998; 13(Suppl 4): 39–43.

    Article  PubMed  Google Scholar 

  14. Besarab A, et al.... NEJM 1998; 339: 584–590.

    Article  PubMed  CAS  Google Scholar 

  15. Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol 1998; 81: 7B–12B.

    Article  PubMed  CAS  Google Scholar 

  16. Bostom AG, Silbershatz H, Rosenberg IH, Selhub J, D’Agostino RB, Wolf PA, Jacques PF, Wilson PW. Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women. Arch Int Med 1999; 159: 1077–1080.

    Article  CAS  Google Scholar 

  17. Bostom AG, Shemin D, Verhoef P, Nadeau Mr, Jacques PF, Selhub J, Dworkin L, rosengerg IH. Elevated fasting total plasma homocysteine levels and cardiovascular disease outcomes in maintenance dialysis patients. A prospective study. Arteriosclerosis, Thromb Vasc Biol 1997; 17: 2554–2558.

    Article  CAS  Google Scholar 

  18. Perna AF, Castaldo P, Ingrosso D, De Santo NG. Homocysteine, a new cardiovascular risk factor, is also a powerful uremic toxin. J Nephrol 1999; 12: 230–240.

    PubMed  CAS  Google Scholar 

  19. Bostom AG, Lathrop L. Hyperhomocysteinemia in end-stage renal disease: prevalence, etiology, and potential relationship to arteriosclerotic outcomes. Kidney Intern 1997; 52: 10–20.

    Article  CAS  Google Scholar 

  20. Lindner A, et al. Accelerated athero — in prolonged maintenance hemodialysis. NEJM 1974; 290: 697–701.

    Article  PubMed  CAS  Google Scholar 

  21. Panichi V, Migliori M, De Pietro S, Taccola D, Bianchi AM, Norpoth M, Giovannini L, Palla R, Tetta C. C-reactive protein as a marker of chronic inflammation in uremic patients. Blood Purification 2000; 18: 183–190.

    Article  PubMed  CAS  Google Scholar 

  22. Hertzog CA, Ma JZ, Collins AJ. Poor long-term survival after acute myocardial infarction among patients on long-term dialysis. N Engl J Med 1998; 339: 799–805.

    Article  Google Scholar 

  23. Herzog CA. Acute myocardial infarction in patients with end-stage renal disease. Kidney Intern 1999; 56(Suppl71): S130–S133.

    Article  Google Scholar 

  24. Kong TQ, Dacanay S, Hsieh AA. Features of acute myocardial infarction in patients on chronic hemodialysis. Circulation 1993; 88(Suppl I): I–49.

    Google Scholar 

  25. Ifudu O, Miles AM, Friedman EA. Hemodialysis immediately after acute myocardial infarction. Nephron 1996; 74:104–109.

    Article  PubMed  CAS  Google Scholar 

  26. Bloch MJ, et al. Prevention of recurrent pulmonary edema... Am J Hyperten 1999; 12: 1–7.

    Article  CAS  Google Scholar 

  27. Herzog CA, Ma JZ, Collins AJ. Long-term survival of dialysis patients receiving thrombolytic therapy for acute myocardial infarction in the United States. Circulation 1999; 100(Suppl 100): I–304.

    Google Scholar 

  28. Van Lente F, McErlean ES, DeLuca SA, Peacock WF, Rao JS, Nissen SE. Ability of troponins to predict adverse outcomes in patients with renal insufficiency and suspected acute coronary syndromes: a case matched study. J Am Coll Cardiol 1999; 33: 471–478.

    Article  PubMed  Google Scholar 

  29. Roppolo LP, Fitzgerald R, Dillow J, Ziegler T, Rice M, Maisel A. A comparison of troponin T and troponin I as predictors of cardiac events in patients undergoing chronic dialysis at a Veteran’s Hospital: a pilot study. J Am Coll Cardiol 1999; 34: 448–454.

    Article  PubMed  CAS  Google Scholar 

  30. Willging S, Keller F, Steinbach G. Specificity of cardiac troponins I and T in renal disease. Clin Chem Lab Med 1998; 36: 87–92.

    Article  PubMed  CAS  Google Scholar 

  31. Kannel WB. Lipids, diabetes and coronary heart disease: insights from the Framingham Study. Am Heart J 1985; 110: 1100–1107.

    Article  PubMed  CAS  Google Scholar 

  32. Tzivoni D, Benhorin J, Stern S. Significance and management of silent myocardial ischemia. Adv Cardiol 1990; 37: 312–319.

    PubMed  CAS  Google Scholar 

  33. Harnett JD, Parfrey PS. Cardiac disease in uremia. Semin Nephrol 1994; 14: 245–252.

    PubMed  CAS  Google Scholar 

  34. Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure. The Framingham Study. Am J Cardiol 1974; 34: 29–34.

    Article  PubMed  CAS  Google Scholar 

  35. Sowers JR, Williams M, Epstein M, Bakris G. Hypertension in patients with diabetes. Strategies for drug therapy to reduce complications. Postgrad Med 2000; 107: 47–54, 60.

    Article  PubMed  CAS  Google Scholar 

  36. Guzman CB, Sowers JR. Special considerations in the therapy of diabetic hypertension. Progress Cardiovasc Dis 1999; 41: 461–470.

    Article  CAS  Google Scholar 

  37. Hsu CH. Are we mismanaging calcium and phosphate metabolism in renal failure? Am J Kidney Dis 1995; 29: 241–649.

    Google Scholar 

  38. Schwartz U, Buzello M, Ritz E, Stein G, Raabe G, Wiest G, Mall G, Amann K. Morphology of coronary atherosclerotic lesions in patients with end-stage-renal failure. Nephrol Dial Transplant 2000; 15: 218–223.

    Article  Google Scholar 

  39. Bommer J, Strohbeck E, Goerich J, Bahner M, Zuna I. Arteriosclerosis in dialysis patients. Int J Artif Organs 1996; 19: 638–644.

    PubMed  CAS  Google Scholar 

  40. Raggi P. Detection and quantification of cardiovascular calcifications with electron beam tomography to estimate risk in hemodialysis patients. Clin Nephrol 2000; 54: 325–333.

    PubMed  CAS  Google Scholar 

  41. Ribeiro S, Ramos A, Brandao A, Rebelo JR, Guerra A, Resina C, Vila-Lobos A, Carvalho F, Remedio F, Ribeiro F. Cardiac valve calcification in haemodialysis patients: role of calcium-phosphate metabolism. Nephrol Dial Transplant 1998; 13: 2037–2040.

    Article  PubMed  CAS  Google Scholar 

  42. Malergue MC, Urena P, Prieur P, Guedon-Rapoud C, Petrove M. Incidence and development of aortic stenosis in chronic hemodialysis. An ultrasonographic and biological study of 112 patients. Archives des Maladies du Coeur et des Vaisseaux 1997; 90: 1595–1601.

    PubMed  CAS  Google Scholar 

  43. Gruppo Hemodialisi E Pathologie Cardiovasculari. Multicenter, cross-sectional study of ventricular arrhythmias in chronically hemodialyzed patients. Lancet 1988; 2: 305–309

    Google Scholar 

  44. Aker S, Ivens K, Guo Z, Grabensee B, Heering P. Cardiovascular complications after renal transplantation. Transpl Proc 1998; 30(5): 2039–2042.

    Article  CAS  Google Scholar 

  45. Koch M, Gradaus F, Schoebel F, Leschke M, Grabensee B. Relevance of conventional cardiovascular risk factors for the prediction of coronary disease in diabetic patients on renal replacement therapy. Nephrol Dial Transplant 1997; 12: 1187–1191.

    Article  PubMed  CAS  Google Scholar 

  46. Braun WE, Philips DF, Vidt DG, Novic AC, Nakamoto S, Popowniak KL, Paganini E, Magnusson M, Pohl M, Steinmuller DR. Coronary artery disease in 100 diabetics with end stage renal failure. Transplant Proc 1984; 16(3): 603–607.

    PubMed  CAS  Google Scholar 

  47. Lorber MI, Van Buren CT, Flechner SM, et al. Pretransplant coronary arteriography for diabetic renal transplant recipients. Transplant Proc 1987; 19: 1539–1541

    PubMed  CAS  Google Scholar 

  48. Manske CL, Wang Y, Wilson RF. Coronary revascularization may improve short term survival in insulin-dependent diabetics considered for renal transplantation. Circulation 1991; 84(Suppl II): II–516.

    Google Scholar 

  49. Herzog CA, Marwick TH, Pheley AM, White CW, Rao VK, Dick CD. Dobutamine stress echocardiography for the detection of significant coronary artery disease in renal transplant candidates. Am J Kidney Dis 1999; 33(6): 1080–1090.

    Article  PubMed  CAS  Google Scholar 

  50. Azar RR, Prpic R, Ho KKL, et al. Outcome of coronary stenting in patients with end-stage renal disease. Circulation 1999; 100(Suppl I): I–365.

    Google Scholar 

  51. Gruberg L, Cury B, Duncan CC, et al. Does contemporary percutaneous coronary intervention improve the otherwise dismal prognosis of patients with end stage renal disease on dialysis? Circulation 1999; 100(Suppl I): I–366.

    Google Scholar 

  52. Weintraub WS, Kosinski A, Culler S. Comparison of outcome after coronary angioplasty and coronary surgery for multivessel coronary artery disease in persons with diabetes. Am Heart J 1999; 138(5 Pt 1): S394–S399.

    PubMed  CAS  Google Scholar 

  53. King SB 3rd, Kosinski AS, Guyton RA, Lembo NJ, Weintraub WS. Eight-year mortality in the Emory Angioplasty versus Surgery Trial (EAST). J Am Coll Cardiol 2000; 35: 1116–1121.

    Article  PubMed  Google Scholar 

  54. Barsness GW, Peterson ED, Ohman EM, Nelson CL, DeLong ER, Reves JG, Smith PK, Anderson RD, Jones RH, Mark DB, Califf RM. Relationship between diabetes and long-term survival after coronary bypass and angioplasty. Circulation 1997; 96: 2551–2556.

    Article  PubMed  CAS  Google Scholar 

  55. Herzog CA. The optimal method of coronary revascularization in dialysis patients: choosing between a rock and a hard place. The Intern J Artifical Organs 2000; 23: 215–218.

    CAS  Google Scholar 

  56. Simsir SA, Kohlman-Trigoboff D, Flood R, Lindsay J, Smith BM. A comparison of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty in patients on hemodialysis. Cardiovasc Surg 1998; 6: 500–505.

    Article  PubMed  CAS  Google Scholar 

  57. Marso SP, Gimple LW, Philbrick JT, DiMarco JP. Effectiveness of percutaneous coronary interventions to prevent recurrent coronary events in patients on chronic hemodialysis. Am J Cardiol 1998; 82: 378–380.

    Article  PubMed  CAS  Google Scholar 

  58. Schoebel FC, Gradaus F, Ivens K, et al. Restenosis after elective coronary balloon angioplasty in patients with end stage renal disease: a case-control study using quantitative coronary angiography. Heart 1997; 78: 337–342.

    PubMed  CAS  Google Scholar 

  59. Schoebel FC, Gradaus F, Ivens K, Heering P, Jax TW, Grabensee B, Strauer BE, Leschke M. Restenosis after elective coronary balloon angioplasty in patients with end stage renal disease: a case-control study using quantitative coronary angiography. Heart 1997; 78: 337–342.

    PubMed  CAS  Google Scholar 

  60. Koyanagi T, Nishida H, Kitamura M, et al. Comparison of clinical outcomes of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty in renal dialysis patients. Ann Thorac Surg 1996; 61: 1793–1796.

    Article  PubMed  CAS  Google Scholar 

  61. Rinehart AL, Herzog CA, Collins AJ, Flack JM, Ma JZ, Opsahl JA. A comparison of coronary angioplasty and coronary artery bypass grafting outcomes in chronic dialysis patients. Am J Kidney Dis 1995; 25: 281–290.

    Article  PubMed  CAS  Google Scholar 

  62. Ahmed WH, Shubrooks SJ, Gibson M, Bairn DS, Bittl JA. Complications and long-term outcome and after percutaneous coronary angioplasty in chronic hemodialysis patients. Am Heart J 1994; 128: 252–255.

    Article  PubMed  CAS  Google Scholar 

  63. Reusser LM, Osborn LA, White HJ, Sexson R, Crawford MH. Increased morbidity and coronary angioplasty in patients on chronic hemodialysis. Am J Cardiol 1994; 73: 965–967.

    Article  PubMed  CAS  Google Scholar 

  64. Takeshita S, Isshiki T, Tagawa H, Yamaguchi T. Percutaneous transluminal coronary angioplasty for chronic dialysis. J Invasive Cardiol 1993; 5: 345–350.

    PubMed  CAS  Google Scholar 

  65. Kahn JK, Rutherford BD, McConahay DR, Johnson WL, Giorgi LV, Hartzler GO. Short-and long-term outcome of percutaneous transluminal coronary angioplasty in chronic dialysis patients. Am Heart J 1990; 119: 484–489.

    Article  PubMed  CAS  Google Scholar 

  66. Herzog CA, Ma JZ, Collins AJ. Long-term outcome of dialysis patients in the United States with coronary revascularization procedures. Kidney Int 1999; 56: 324–332.

    Article  PubMed  CAS  Google Scholar 

  67. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996; 335: 217–225.

    Article  Google Scholar 

  68. Herzog CA, Ma JZ, Collins AJ. Long-term survival of dialysis patients in the United States after coronary artery bypass surgery, coronary angioplasty and coronary stenting. Circulation 1999; 100(Suppl I): 1–365.

    Google Scholar 

  69. Ma JZ, Collin AJ, Herzog CA. The likelihood of repeated coronary revascularization procedures (CRP) after first CRP in dialysis patients. J Am Soc Nephrol 1999; 10: 249A.

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, SUNY, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York, 11203

    Luther T. Clark M.D. (Chief, Division of Cardiology Professor of Medicine)

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  1. Luther T. Clark M.D.
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  2. Oluwole Abe
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Editors and Affiliations

  1. Downstate Medical Center, State University of New York, New York, USA

    Eli A. Friedman M.D.

  2. Colombia University, New York, USA

    Francis A. L’Esperance Jr. M.D.

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Clark, L.T., Abe, O. (2002). Prevention, Diagnosis and Management of Heart Disease in Patients with Renal Failure. In: Friedman, E.A., L’Esperance, F.A. (eds) Diabetic Renal-Retinal Syndrome. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0614-9_12

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  • DOI: https://doi.org/10.1007/978-94-010-0614-9_12

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