Congestive Heart Failure in Dialysis Patients

Parfrey, Patrick S.; Harnett, John D.; Griffiths, Sheila M.; Gault, M. H.; Barré, Paul E.

doi:10.1001/archinte.1988.00380070037010

Cited by 106 publications

(57 citation statements)

References 46 publications

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“…Cardiac Failure: Persistent or recurrent dyspnea plus two of the followings: Raised jugular venous pressure, bibasilar crackles, pulmonary venous hypertension or interstitial edema on chest X-ray 12 .…”

Section: Methodsmentioning

confidence: 99%

“…Cardiovascular disease is by far the leading cause of morbidity and mortality in CKD patients, accounting for almost 40% of hospitalizations 1 and almost 50% of deaths 1,2 . After stratification for age, race and gender, the cardiovascular mortality rate in End Stage Renal Disease (ESRD) patients is [10][11][12][13][14][15][16][17][18][19][20] times that in the general population 3 . At the time of starting renal replacement therapy, prevalence of cardiovascular disease among Chronic Kidney Disease (CKD) patients is high 1,4,5 .…”

Section: Introductionmentioning

confidence: 99%

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Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Saha

Faroque

et al. 2012

Bangladesh Med Res Counc Bull

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The study was carried out to see prevalence of Chronic Kidney Disease (CKD) specific cardiovascular risk factors and cardiovascular events among patients with Chronic Kidney Disease stage-V (CKD-V) before starting dialysis therapy in the department of Nephrology of National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. Among CKD specific cardiovascular risk factors, anemia showed the highest prevalence (96.7%) in study population. More than fifty percent of CKD-V patients had both hypocalcaemia and hyperphosphataemia. Calcium-Phosphate Product (CaXP) was elevated among 23 percent of the population. C-reactive protein, an acute phase protein was positive in 78% of CKD-V patients. Besides, among traditional risk factors, Hypertension and Diabetes Mellitus were present in 83.3% and 23% of the study population respectively. The prevalence of cardiovascular events among CKD-V patients showed that 18.3% had ischemic heart disease, 38% heart failure, 4.7% arrhythmia and 9% left ventricular hypertrophy. Females were significantly prone to develop cardiovascular events than their male counterpart (p=0.028). Diabetes was significantly higher in patients with cardiovascular complications than in patients without cardiovascular complications (p=0.021).

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Saha

Faroque

et al. 2012

Bangladesh Med Res Counc Bull

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“…The occurrence of symptomatic clinical pulmonary congestion by volume overload is increased in the presence of compromised LV function [21]. About half of asymptomatic ESRD patients have compromised LV systolic function [22].…”

Section: Lung Congestion In Dialysis Patients: Risk Factors and The Pmentioning

confidence: 99%

Lung Congestion as a Risk Factor in End-Stage Renal Disease

et al. 2013

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Background: Lung congestion is emerging as a pervasive, insidious problem in end-stage renal disease (ESRD) patients on dialysis. Summary: Chest ultrasound (US), a novel, easy-to-perform, cheap technique, which is currently applied for objective monitoring of pulmonary congestion in patients with heart failure in Europe, allows reliable quantification of lung water in clinical practice. Before hemodialysis (HD), about 60% of ESRD patients displayed moderate-severe lung congestion and this alteration is frequently asymptomatic. Lung congestion is reduced but not abolished by ultrafiltration dialysis, and about one third to one fourth of patients still have excessive lung water after dialysis. Lung congestion is also prevalent in patients on peritoneal dialysis (PD), and in apparently asymptomatic HD and PD patients this alteration is strongly associated with poor physical performance. Lung water in HD patients correlates in an inverse fashion with echocardiographic parameters of systolic and diastolic function, but it is only weakly related with hydration status measured by bioimpedance analysis. Moderate-severe lung congestion is a strong predictor of death and cardiovascular events and provides prognostic information independent of NYHA class, and traditional and nontraditional risk factors in ESRD patients on HD. Key Messages: Systematic application of chest US in ESRD patients shows that hidden or clinically manifest lung congestion is exceedingly frequent in this population. This alteration largely reflects left ventricular disorders superimposed on volume overload. The clinical usefulness of systematic application of chest US in ESRD remains to be tested in a formal clinical trial.

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“…These findings are in consistent with the findings by Levin. 35 In cohort followed as a part of an observational study, it was found that approximately 30-40% of all patients seen by nephrologists have a history of IHD. 36,2,26,37 In this study heart failure was detected in 35% of patient.…”

Section: Discussionmentioning

confidence: 99%

“…The role of impaired kidney function and heart failure prior to dialysis has not been well studied. 35 In the Canadian multi-centre study, it was found that, those patients who had a change or worsening NYHA (New York Heart Association) class also had anaemia and LVH. An increase in heart failure may simply be due to cardiac decompensation after structural changes.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Risk Factors for Cardiovascular Complications in Patients with Chronic Kidney Disease (CKD) Stage III-V before Dialysis

Rashid

Yesmine

et al. 2014

Univ. Heart J.

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Background: Chronic Kidney Disease is a major public health and clinical problem throughout the world including Bangladesh. The prevalence of cardiovascular complications is much higher in patients with CKD regardless of stages than normal population. Considering this view, a cross sectional study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, with an aim to assessing the cardiovascular complications & associated risk factors among the patients with chronic kidney disease (CKD) stage III-V before dialysis. Methods: A total of 109 patients were selected consecutively who had a diagnosis of CKD and an estimated GFR of less than 60 ml/min/1.73m2 of stages III to V and who had not received any form of renal replacement therapy, during a period of June 2006 to July 2007. Results: The study included 63 males and 46 females with age ranging from 18 to 65 years having a mean age 45.5±12.2 years. Left ventricular failure, left ventricular hypertrophy (by ECG and echocardiography), cardiomegally by X-ray were identified as significant cardiovascular complications among the patients of CKD stage V (p<0.05). However , logistic regression analysis revealed that hypertension and CKD stages appeared to be the important predictors of cardiovascular complications p<0.05). Data analysis found that hypertension, smoking and anemia appeared to be important risk factors for cardiovascular complications in CKD patients (p<0.05) by bi-variate analysis. Conclusion: Though the study findings did not generalize the CKD patients in Bangladesh due to small sample size, however, heart failure and left ventricular hypertrophy significantly appeared to be the main cardiovascular complications in CKD stage V compared to other two stages (stage III and IV)(p<0.05). Anemia, hypertension were identified as important risk factors (p<0.05). DOI: http://dx.doi.org/10.3329/uhj.v9i1.19508 University Heart Journal Vol. 9, No. 1, January 2013; 25-32

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Congestive Heart Failure in Dialysis Patients

Cited by 106 publications

References 46 publications

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Lung Congestion as a Risk Factor in End-Stage Renal Disease

Assessment of Risk Factors for Cardiovascular Complications in Patients with Chronic Kidney Disease (CKD) Stage III-V before Dialysis

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Congestive Heart Failure in Dialysis Patients

Cited by 106 publications

References 46 publications

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Lung Congestion as a Risk Factor in End-Stage Renal Disease

Assessment of Risk Factors for Cardiovascular Complications in Patients with Chronic Kidney Disease (CKD) Stage III-V before Dialysis

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Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital

Chronic Kidney Disease specific cardiovascular risk factors among non dialytic patients with Chronic Kidney Disease stage-VAn experience of a specialized hospital