The Natural History of Myocardial Disease in Dialysis Patients

  • Patrick S. Parfrey
  • John D. Harnett
Part of the Topics in Renal Medicine book series (TIRM, volume 10)


In maintenance-dialysis patients, statistically significant independent predictors of death that are present before treatment for end-stage renal disease (ESRD) begins include age, duration of diabetes, and left-sided heart failure [1]. Death is most often due to cardiac disease, which accounted for 36% of deaths in Canada in 1988 (figure 3–1) [2]. Despite multiple advances in the therapy of chronic uremia, cardiac disease has always been the most important cause of death. The most common autopsy-ascertained causes of death in nondiabetic patients are congestive heart failure (37%), acute myocardial infarction (13%), and tamponading pericarditis (8%) [3].


Congestive Heart Failure Left Ventricular Hypertrophy Dilate Cardiomyopathy Dialysis Patient Hypertrophic Cardiomyopathy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hutchinson TA, Thomas DC, MacGibbon B. 1982. Predicting survival in adults with endstage renal disease: An age equivalence index. Ann Intern Med 96:417–423.PubMedGoogle Scholar
  2. 2.
    Canadian Organ Replacement Register. 1990. CORR 1988 Annual Report. Don Mills, Ontario: Hospital Medical Records Institute, April, p.61.Google Scholar
  3. 3.
    Clyne N, Luis L-E, Pehrsson SK. 1986. Occurrence and significance of heart disease in uremia: An autopsy study. Scand J Urol Nephrol 20:307–311.PubMedCrossRefGoogle Scholar
  4. 4.
    Churchill DN for the Canadian Hemodialysis Morbidity Study Group. 1990. Results of the Canadian Morbidity Study in end stage renal disease patients treated by hemodialysis. Semin Nephrol 10:66–71.Google Scholar
  5. 5.
    Parfrey PS, Harnett JD, Griffiths SM, Gault MH, Barre P. 1988. Congestive heart failure in dialysis patients. Arch Intern Med 148:1519–1525.PubMedCrossRefGoogle Scholar
  6. 6.
    Harnett JD, Parfrey PS, Gault MH, et al. 1988. Left ventricular hypertrophy in endstage renal disease. Nephron 48:107–115.PubMedCrossRefGoogle Scholar
  7. 7.
    Parfrey PS, Harnett JD, Griffiths S, Gault MH, Barre PE, Guttmann RD. 1987. Low output left ventricular failure in endstage renal disease. Am J Nephrol 7:184–191.PubMedCrossRefGoogle Scholar
  8. 8.
    Parfrey PS, Griffiths SM, Harnett JD, et al. 1990. Outcome of congestive heart failure, dilated cardiomyopathy, hypertrophic hyperkinetic disease, and ischemie heart disease in dialysis patients. Am J Nephrol 10:213–221.PubMedCrossRefGoogle Scholar
  9. 9.
    Parfrey PS, Harnett JD, Griffiths SM, et al. 1990. The clinical course of left ventricular hypertrophy in dialysis patients. Nephron 55:114–120.PubMedCrossRefGoogle Scholar
  10. 10.
    London GM, Fabiani F, Marchais SJ, et al. 1987. Urémie cardiomyopathy: an inadequate left ventricular hypertrophy. Kidney Int 31:973–980.PubMedCrossRefGoogle Scholar
  11. 11.
    London GM, De Vernejoul MC, Fabiani F, et al. 1987. Secondary hyperparathyroidism and cardiac hypertrophy in hemodialysis patients. Kidney Int 32:900–927.PubMedCrossRefGoogle Scholar
  12. 12.
    Rostand SG, Kirk KA, Rutsky EA. 1982. Relationship of coronary risk factors to hemodialysis-associated ischémie heart disease. Kidney Int 22:304–308.PubMedCrossRefGoogle Scholar
  13. 13.
    Rostand SG, Kirk KA, Rutsky EA. 1984. Dialysis-associated ischemie heart disease: insights from coronary angiography. Kidney Int 25:653–659.PubMedCrossRefGoogle Scholar
  14. 14.
    Huting J, Kramer W, Charra B, Laurent G, Wizemann V, Schutterle G. 1989. Asymmetric septal hypertrophy and left atrial dilatation in patients with end stage renal disease on longterm hemodialysis. Clin Nephrol 32:276–283.PubMedGoogle Scholar
  15. 15.
    Wizemann V, Kramer W. 1988. Choice of ESRD treatment strategy according to cardiac status. Kidney Int 33(Suppl 24):S–191–S–195.Google Scholar
  16. 16.
    Echeverria HH, Bilsher MS, Myerburg RJ, et al. 1983. Congestive heart failure: echocardiographic insights. Am J Med 75:750–755.PubMedCrossRefGoogle Scholar
  17. 17.
    Massie B, Ports T, Chatterjee K, et al. 1981. Longterm vasodilator therapy for heart failure: clinical response and its relationship to hemodynamic measurements. Circulation 63:269–278.PubMedCrossRefGoogle Scholar
  18. 18.
    Franciosa JA, Wilen M, Ziesche S, Cohn JN. 1983. Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 51:831–836.PubMedCrossRefGoogle Scholar
  19. 19.
    Kannel WB, Plehn JF, Cupples LA. 1988. Cardiac failure and sudden death in the Framingham study. Am Heart J 115:869–875.PubMedCrossRefGoogle Scholar
  20. 20.
    Burt RK, Gupta-Burt S, Suki WN, et al. 1989. Reversal of left ventricular dysfunction after renal transplantation. Ann Intern Med 111:635–640.PubMedGoogle Scholar
  21. 21.
    . Editorial: Natural history of dilated cardiomyopathy. 1986. Lancet 1:248–249.Google Scholar
  22. 22.
    Caforio ALP, Stewart JT, McKenna WJ. 1990. Idiopathic dilated cardiomyopathy. Rational treatment awaits better understanding of pathogenesis. Br MedJ 300:890–891.Google Scholar
  23. 23.
    Oakley C. 1978. Diagnosis and natural history of congestive (dilated) cardiomyopathies. Postgrad Med J 54:440–447.PubMedCrossRefGoogle Scholar
  24. 24.
    Lengyel M, Kokeny M. 1981. Follow up study in congestive (dilated) cardiomyopathy. Acta Cardiol 36:35–48.PubMedGoogle Scholar
  25. 25.
    Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO, Frye RL. 1981. The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 47:525–531.PubMedCrossRefGoogle Scholar
  26. 26.
    Figulla H, Rahlf G, Nieger M, Luid H, Kreuzer H. 1985. Spontaneous hemodynamic improvement or stabilisation and associated biopsy findings in patients with congestive cardiomyopathy. Circulation 71:1095–1104.PubMedCrossRefGoogle Scholar
  27. 27.
    Levy D, Anderson KM, Savage DD, Kannel WB, Christiansen JC, Castelli WP. 1988. Echocardiographically detected left ventricular hypertrophy: prevalence and risk factors. The Framingham Heart Study. Ann Intern Med 108:7–13.Google Scholar
  28. 28.
    Devereux RB, Pickering TG, Alderman MH, Chien S, Borer JS, Laragh JH. 1987. Left ventricular hypertrophy in hypertension: prevalence and relation to pathophysiologic variables. Hypertension 9 (Suppl 2):1153–1160.Google Scholar
  29. 29.
    Hammond IW, Devereux RB, Alderman MH, Lutas EM, Spitzer MC, Crowley JS, Laragh JH. 1986. The prevalence and correlates of echocardiographic left ventricular hypertrophy among employed patients with uncomplicated hypertension. J Am Coll Cardiol 7:639–650.PubMedCrossRefGoogle Scholar
  30. 30.
    Kannel WB, Gordon T, Offutt D. 1969. Left ventricular hypertrophy by electrocardiogram: prevalence, incidence and mortality in the Framingham Study. Ann Intern Med 71:89–105.PubMedGoogle Scholar
  31. 31.
    Kannel WB, Doyle JT, McNamara PM, Quickenton P, Gordon T. 1975. Precursors of sudden coronary death: Factors related to the incidence of sudden death. Circulation 51:606–613.PubMedCrossRefGoogle Scholar
  32. 32.
    Casale PN, Devereaux RB, Milner M, Zullo G, Harshfield GA, Pickering TG, Laragh JH. 1986. Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann Intern Med 105:173–178.PubMedGoogle Scholar
  33. 33.
    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. 1989. Left ventricular mass and incidence of coronary heart disease in an elderly cohort: The Framingham Heart Study. Ann Intern Med 110:101–107.PubMedGoogle Scholar
  34. 34.
    Aronow WS, Koenigsberg M, Schwartz KS. 1988. Usefulness of echocardiographic left ventricular hypertrophy in predicting new coronary events and atherothrombotic brain infarction in patients over 62 years of age. Am J Cardiol 61:1130–1132.PubMedCrossRefGoogle Scholar
  35. 35.
    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. 1990. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham heart study. N Engl J Med 322:1561–1566.PubMedCrossRefGoogle Scholar
  36. 36.
    Blake J, Devereux RB, Herrold EM, Jason M, Fisher J, Borer JS, Laragh JH. 1988. Relation of concentric left ventricular hypertrophy and extracardiac target organ damage to supranormal left ventricular performance in established essential hypertension. Am J Cardiol 62:246–252.PubMedCrossRefGoogle Scholar
  37. 37.
    Topol EJ, Traill TA, Fortuin NJ. 1985. Hypertensive hypertrophic cardiomyopathy of the elderly. N Engl J Med 312:277–283.PubMedCrossRefGoogle Scholar
  38. 38.
    Roig E, Betriu A, Castaner A, Magrina J, Sanz G, Navarro-Lopez F. 1981. Disabling angina pectoris with normal coronary arteries in patients undergoing long-term hemodialysis. Am J Med 71:431–434.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Patrick S. Parfrey
  • John D. Harnett

There are no affiliations available

Personalised recommendations