Ischemic heart disease in patients undergoing dialysis.

Venkatesh Kumar Ariyamuthu, Sudarshan Balla, Kunal Chaudhary

Research output: Contribution to journalArticle

Abstract

Cardiovascular disease is the most common cause of death in patients with end-stage renal disease (ESRD) who are undergoing chronic dialysis. Diabetes and hypertension, the 2 leading causes of ESRD, contribute to the pathogenesis of ischemic heart disease (IHD) in these patients, as do other traditional risk factors (eg, dyslipidemias, smoking, and sedentary lifestyle). However, patients with ESRD are subject to several unique risk factors that contribute to the development and progression of IHD. Chronic volume overload and anemia, leading to left ventricular hypertrophy, and deranged calcium-phosphate metabolism with vascular and coronary calcification, contribute to the pathogenesis of IHD. Other risk factors that have been implicated include oxidative stress, homocysteine, and myocardial stunning while undergoing dialysis treatment. Additional risk factors include erythropoietin use for treating anemia, as well as use of calcium-based phosphate binders. The complex pathogenesis of IHD in such patients poses unique challenges to its management. Serological biomarkers and sophisticated imaging techniques are being developed to better delineate the pathological process and enhance disease detection. A combination of medical and surgical approaches is necessary to treat IHD. In this article, we discuss the pathogenesis and management of IHD.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalHospital practice (1995)
Volume40
Issue number4
StatePublished - Oct 1 2012

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Myocardial Ischemia
Dialysis
Chronic Kidney Failure
Anemia
Myocardial Stunning
Sedentary Lifestyle
Vascular Calcification
Left Ventricular Hypertrophy
Homocysteine
Pathologic Processes
Dyslipidemias
Erythropoietin
Cause of Death
Oxidative Stress
Cardiovascular Diseases
Biomarkers
Smoking
Hypertension
calcium phosphate

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ischemic heart disease in patients undergoing dialysis. / Ariyamuthu, Venkatesh Kumar; Balla, Sudarshan; Chaudhary, Kunal.

In: Hospital practice (1995), Vol. 40, No. 4, 01.10.2012, p. 33-39.

Research output: Contribution to journalArticle

Ariyamuthu, VK, Balla, S & Chaudhary, K 2012, 'Ischemic heart disease in patients undergoing dialysis.', Hospital practice (1995), vol. 40, no. 4, pp. 33-39.
Ariyamuthu, Venkatesh Kumar ; Balla, Sudarshan ; Chaudhary, Kunal. / Ischemic heart disease in patients undergoing dialysis. In: Hospital practice (1995). 2012 ; Vol. 40, No. 4. pp. 33-39.
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