The Influence of Renal Replacement Therapy on Cardiac Disease in the Patient with End-Stage Renal Disease

Journal of Clinical and Basic Cardiology 2001; 4 (2): 101-107

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Keywords: Dialyse,  Herzkrankheit,  Herztransplantation,  kardiovaskulärer Risikofaktor,  cardiac disease,  cardiovascular risk factors,  dialysis,  transplantation

Cardiac disease exerts a major influence on the morbidity and mortality of patients suffering from end-stage renal disease (ESRD), particularly when treated with dialysis. This paper reviews the distinct impact of each renal replacement therapy, haemodialysis, peritoneal dialysis, and kidney transplantation, on the presence of some cardiovascular risk factors. The following topics are discussed: the prevalence of cardiovascular abnormalities at start and during each analysis modality; among them left ventricular abnormalities, ischaemic heart disease and cardiac arrhythmias; the evolution of the cardiac abnormalities after renal transplantation; the risk factors for cardiac disease: hypertension, volume overload, compliance of the great vessels, anaemia, dyslipidaemia, hyperhomocysteinaemia, and hormonal disturbances in female patients. Finally, some therapeutic considerations in the dialysis patients with coronary heart disease are briefly discussed.