Recent studies have brought the news that cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD). It is apparent that nephrology care providers must focus more attention and effort on coronary disease issues. Towards that end, RenalWEB has created a Topic Page on this important topic.

Here are the scientific journals of the American Heart Association.

April 2, 2002 - Here is the latest information on cardiovascular issues in end-stage renal disease:

• "Is folate a promising agent in the prevention and treatment of cardiovascular disease in patients with renal failure?" - abstract from Kidney International (April 2002)
  
  
  
• "Moderate renal insufficiency and the risk of cardiovascular mortality: Results from the NHANES I" - abstract from Kidney International (April 2002)
  
  
  
• "Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality" - abstract from AJKD (American Journal of Kidney Diseases) April 2002
  
  
  
• "Association between interleukin-6 and carotid atherosclerosis in hemodialysis patients" - abstract from Kidney International (March 2002).
  
  
  
• "Statins May Inhibit Calcium Growth on Aortic Valve in Elderly" - summary from Doctor's Guide

February 22, 2002 - The March edition of the Journal of the American Society of Nephrology (JASN) has two articles on cardiovascular issues:

• "Nocturnal Hypoxemia Predicts Incident Cardiovascular Complications in Dialysis Patients" - abstract from JASN

  Conclusion: "This study adds weight to the hypothesis that nocturnal hypoxemia in dialysis patients represents an important cardiovascular risk factor."

  
  
• "Renal Insufficiency and Subsequent Death Resulting from Cardiovascular Disease in the United States" - abstract from JASN

  Conclusion: "This study indicates that, in a representative sample of the United States general population, renal insufficiency is independently associated with increased cardiovascular disease-related and all-cause mortality rates."

February 20, 2002 - The results of a study on the the frequency and severity of cardiovascular calcification in hemodialysis patients appear in the current issue of the Journal of the American College of Cardiology. Researchers concluded that coronary artery calcification is common, severe, and associated with ischemic cardiovascular disease in adult patients with end-stage renal disease. Summary from PRNewswire/Yahoo. (link is no longer available)

Here is the abstract of the article entitled "Cardiac calcification in adult hemodialysis patients: A link between end-stage renal disease and cardiovascular disease?"

In May 2000, an article appeared in the New England Journal of Medicine that demonstrated for the first time that young ESRD patients have a high incidence of coronary artery calcification. Here is the abstract of the article entitled "Coronary-Artery Calcification in Young Adults with End-Stage Renal Disease Who Are Undergoing Dialysis"


February 14, 2002 - The latest issue of the American Journal of Kidney Disease has two pieces related to cardiovascular disease in dialysis patients:

• "Safety and efficacy of simvastatin in hypercholesterolemic patients undergoing chronic renal dialysis" - abstract from AJKD

  Conclusion: "The incidence of clinical and laboratory adverse experiences were not increased in the simvastatin-treated patients compared with placebo. Simvastatin appears to be a safe and effective treatment for the reduction of serum non-HDL cholesterol levels in both HD and, particularly, CAPD patients."

  
  
• Editorial: "Safety and efficacy of simvastatin in patients undergoing chronic renal dialysis: Are we ready to treat hypercholesterolemia?" - full text piece from AJKD

January 25, 2002 - The "Framingham Study" of kidney disease, led by the University of Pennsylvania School of Medicine, will track the health of 3,000 Chronic Renal Insufficiency (CRI) sufferers from seven clinical sites across the country. CRI often leads to death from cardiovascular complications related to high blood pressure before kidney disease progresses to end-stage.

The National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) of the National Institutes of Health has committed over $40 million to begin the project and see it through the first seven years of operation. Press release from the University of Pennsylvania Health System.

January 23, 2002 - Here is the latest information on cardiovascular issues in end-stage renal disease:

• "Peripheral Vascular Disease Risk Factors among Patients Undergoing Hemodialysis" - abstract from JASN (Journal of the American Society of Nephrology)
  
  
  
• "Serum Levels of Macrophage Colony-Stimulating Factor and Aortic Calcification in Hemodialysis Patients" - abstract from American Journal of Nephrology
  
  
  
• "Epidemiology of Vascular Disease in Renal Failure" - abstract from Blood Purification
  
  
  
• "Medial artery calcification in ESRD patients is associated with deposition of bone matrix proteins" - abstract from KI (Kidney International)
  
  
  
• "Pulse pressure and risk of total mortality and cardiovascular events in patients on chronic hemodialysis" - abstract from KI
  
  
  
• "Systolic time intervals in haemodialysis patients with normal ejection fraction: An echocardiographic study" - full-text article from Nephrology

December 22, 2001 - Asymmetrical dimethylarginine (ADMA), a naturally occurring compound linked to blood vessel function, is found in high levels in dialysis patients and is also associated with a higher incidence of coronary events in patients not on dialysis. Story from Reuters Health/Yahoo. (link is no longer available)

December 3, 2001 - Here is the latest information on cardiovascular issues in end-stage renal disease:

• "Cardiovascular Disease in Patients With Chronic Kidney Disease: Getting to the Heart of the Matter" - abstract of symposium proceedings from AJKD (American Journal of Kidney Diseases).
  
  
  
• "Alterations of Left Ventricular Hypertrophy in and Survival of Patients Receiving Hemodialysis: Follow-up of an Interventional Study" - abstract from JASN
  
  
  
• "Prognostic Impact of the Indexation of Left Ventricular Mass in Patients Undergoing Dialysis" - abstract from JASN.
  
  
  
• "Soluble Fas Is a Marker of Coronary Artery Disease in Patients With End-Stage Renal Disease" - abstract from AJKD
  
  
  
• "Statin-Niacin Combination Sharply Cuts Heart Risk" - abstract from a study published in the New England Journal of Medicine.
  
  
  
• "Statins found to work better in studies than in practice" - story from AMED News.

November 20, 2001 - Here is the latest information on cardiovascular issues in end-stage renal disease:

• "Coronary artery disease in uremia: Etiology, diagnosis, and therapy" - abstract from KI (Kidney International)
  
  
  
• "Erythropoietin and Cardiocirculatory Condition in Aged Patients with Chronic Renal Failure" - abstract from Nephron
  
  
  
• "Effects of uremic serum on isolated cardiac myocyte calcium cycling and contractile function" - abstract from KI
  
  
  
• "Prognostic value of troponin T in hemodialysis patients is independent of comorbidity" - abstract from KI.
  
  
  
• "Blood panel values may predict cardiovascular disease in renal transplant recipients" - article from Reuters Health/Medical Economics. (link is no longer available)
  
  
  
• "Statins are the new aspirin, Oxford researchers say" - full text article from BMJ
  
  
  
• American Heart Association (AHA) applauds introduction of legislation requiring Medicare coverage of cholesterol and lipid screening - press release from AHA

November 1, 2001 - Here is the latest information on cardiovascular issues in end-stage renal disease:

"Arterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease" - abstract from Hypertension.

Summary: "The results of this study showed that the presence and extent of vascular calcifications were strong predictors of cardiovascular and all-cause mortality. Carotid incremental elastic modulus gave additional predictive value."

"A Cross-Sectional Study of the Prevalence and Clinical Correlates of Congestive Heart Failure Among Incident US Dialysis Patients" - abstract from AJKD (American Journal of Kidney Diseases).

Summary: "This national study shows the association of several measures of atherosclerosis and cardiac abnormalities with the presence of CHF at the start of dialysis therapy. It identifies serum albumin as a strong disease correlate and suggests that elevated serum calcium and phosphate levels may be potential risk factors for CHF. This study also suggests that frequent specialist care during this critical period may impact favorably on the prevalence of CHF at the start of ESRD."

"Effects of Long-Term Treatment with Simvastatin on Some Hemostatic Parameters in Continuous Ambulatory Peritoneal Dialysis Patients" - abstract from AJN (American Journal of Nephrology)

Summary: "Simvastatin is an effective hypolipemic agent and favorably affects platelet aggregation, endothelial function and fibrinolysis in CAPD patients."

"Survival and Development of Cardiovascular Disease by Modality of Treatment in Patients with End-Stage Renal Disease" - abstract from JASN.

Summary: "After adjustment for age, gender, and established CVD and stratification by diabetic status, there was no significant between-treatment difference in 4-yr survival (relative risk [RR], 0.91; 95% confidence interval [CI], 0.79 to 1.06). The risk of de novo CVD did not differ significantly by treatment modality."

"Impact of High-Normal Blood Pressure on the Risk of Cardiovascular Disease" - abstract from NEJM (New England Journal of Medicine).

Summary: "High-normal blood pressure is associated with an increased risk of cardiovascular disease. Our findings emphasize the need to determine whether lowering high-normal blood pressure can reduce the risk of cardiovascular disease."

K/DOQI Expands to Include Atherosclerotic Cardiovascular Disease in Dialysis Patients - news release from the NKF (National Kidney Foundation).

All antihypertensive drugs have similar long-term safety and efficacy, study shows - summary from RenalAdvances.com

[This message has been edited by Gary Peterson (edited 07-11-2002).]