NON‐CORONARY HEART DISEASE IN DIALYSIS PATIENTS: Hypertrophy and Fibrosis in the Cardiomyopathy of Uremia—Beyond Coronary Heart Disease

Gross, Marie–Luise; Ritz, Eberhard

doi:10.1111/j.1525-139x.2008.00454.x

Cited by 148 publications

(151 citation statements)

References 180 publications

(196 reference statements)

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…Such cardiomyopathy occurs very early in the course of impaired renal function, both in experimental studies (10) and in human observations. It is characterized by a composite of inappropriate ventricular hypertrophy, marked interstitial fibrosis, microvessel disease with thickening of intramyocardial arteries, and capillary deficit (11). In a small biopsy controlled study, it was shown that cardiac fibrosis was a predictor of death (12).…”

Section: Underlying Cardiac Diseasementioning

confidence: 99%

“…In a small biopsy controlled study, it was shown that cardiac fibrosis was a predictor of death (12). Cardiac fibrosis (causing arrhythmia as a result of reentry circuits) as well as diastolic malfunction (the result of reduced compliance [11]) are the most important causes of cardiac death and potentially future therapeutic targets.…”

Section: Underlying Cardiac Diseasementioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular Problems on Hemodialysis

Ritz

Bommer

2009

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Underlying Cardiac Diseasementioning

confidence: 99%

Section: Underlying Cardiac Diseasementioning

confidence: 99%

Cardiovascular Problems on Hemodialysis

Ritz

Bommer

2009

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

show abstract

“…More than 60% of all cardiac deaths in dialysis patients are attributable to sudden cardiac death and/or arrhythmias (1). Many factors are likely operative in mediating the high cardiac risk seen in dialysis patients and include factors related to underlying diseases (hypertension, diabetes mellitus) and uremia (myocardial fibrosis) (2)(3)(4)(5). In patients treated with hemodialysis (HD), the long interdialytic interval and the myocardial stunning induced by the HD procedure may possibly be additional contributing factors (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

Torlén

Kalantar-Zadeh

Molnar

et al. 2012

Clinical Journal of the American Society of Nephrology

126

134

View full text Add to dashboard Cite

SummaryBackground and objectives Unlike hemodialysis (HD), peritoneal dialysis (PD) is a continuous therapy and does not induce myocardial stunning. Yet, the death risk in HD and PD patients is similar. This study tested the hypothesis that serum potassium abnormalities contribute more to the death risk in PD patients than in HD patients.Design, setting, participants, & measurements Data from patients treated in DaVita facilities between July 1, 2001 and June 30, 2006 (n=10,468 PD patients; n=111,651 HD patients) were used to determine association of serum potassium with mortality.Results PD patients were significantly more likely to have serum potassium ,4 mEq/L, with an adjusted odds ratio of 3.30 (95% confidence interval [95% CI], 3.05, 3.56). There was a U-shaped relationship between timeaveraged serum potassium and all-cause and cardiovascular mortality of PD patients, with adjusted hazards ratios of 1.51 for all-cause mortality for potassium ,3.5 mEq/L (95% CI, 1.29, 1.76) and 1.52 for potassium $5.5 mEq/L (95% CI, 1.32, 1.75). The population-attributable risks for all-cause mortality for serum potassium ,4.0 and $5.5 mEq/L were 3.6% and 1.9%, respectively, in PD patients, and 0.8% and 1.5%, respectively, in HD patients.Conclusions Abnormalities in serum potassium contribute disproportionately to the high death risk in PD patients. This may, in part, account for the equivalent cardiac risk seen with the two therapies.

show abstract

“…Several cardiovascular disease therapies effective in the general population have been entirely ineffective in patients on hemodialysis (HD). However, cardiovascular disease in patients on dialysis is not solely caused by traditional risk factors or the uremic milieu (1). HD itself causes recurrent and cumulative ischemic injury to the heart, brain, and other organs (2).…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of Individualized Dialysate Cooling for Cardiac Protection in Hemodialysis Patients

Odudu

Eldehni

McCann

et al. 2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives Cardiovascular disease is the most common cause of death in patients on hemodialysis (HD). HD-associated cardiomyopathy is appreciated to be driven by exposure to recurrent and cumulative ischemic insults resulting from hemodynamic instability of conventionally performed intermittent HD treatment itself. Cooled dialysate reduces HD-induced recurrent ischemic injury, but whether this confers long-term protection of the heart in terms of cardiac structure and function is not known.Design, setting, participants, & measurements Between September 2009 and January 2013, 73 incident HD patients were randomly assigned to a dialysate temperature of 37°C (control) or individualized cooling at 0.5°C below body temperature (intervention) for 12 months. Cardiac structure, function, and aortic distensibility were assessed by cardiac magnetic resonance imaging. Mean between-group difference in delivered dialysate temperature was 1.2°C60.3°C. Treatment effects were determined by the interaction of treatment group with time in linear mixed models.Results There was no between-group difference in the primary outcome of left ventricular ejection fraction (1.5%; 95% confidence interval, -4.3% to 7.3%). However, left ventricular function assessed by peak systolic strain was preserved by the intervention (-3.3%; 95% confidence interval, -6.5% to -0.2%) as was diastolic function (measured as peak diastolic strain rate, 0.18 s 21 ; 95% confidence interval, 0.02 to 0.34 s 21 ). Reduction of left ventricular dilation was demonstrated by significant reduction in left ventricular end-diastolic volume (-23.8 ml; 95% confidence interval, -44.7 to -2.9 ml). The intervention was associated with reduced left ventricular mass (-15.6 g; 95% confidence interval, -29.4 to -1.9 g). Aortic distensibility was preserved in the intervention group (1.8 mmHg 21 310 23 ; 95% confidence interval, 0.1 to 3.6 mmHg 21 310 23 ). There were no intervention-related withdrawals or adverse events.

show abstract

NON‐CORONARY HEART DISEASE IN DIALYSIS PATIENTS: Hypertrophy and Fibrosis in the Cardiomyopathy of Uremia—Beyond Coronary Heart Disease

Cited by 148 publications

References 180 publications

Cardiovascular Problems on Hemodialysis

Cardiovascular Problems on Hemodialysis

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

Randomized Controlled Trial of Individualized Dialysate Cooling for Cardiac Protection in Hemodialysis Patients

Contact Info

Product

Resources

About