Cardiovascular Disease in Hemodialysis Patients

Cardiovascular disease (CVD) is a most common complication and a chief cause of death in pa‐ tients with end stage renal disease (ESRD) accounting for 45% to 50% of causes of death in ESRD patients. In ESRD patients, mortality due to CVD is 10~30 times higher than in the general pop‐ ulation. 80% patients on maintenance homodialysis (MHD) had cardiovascular complication. In Chinese patients, the prevalence of CVD in young MHD patients was as high as 63.8%, and its characteristics were similar to middleand old-aged MHD patients. This is likely due to ventric‐ ular hypertrophy as well as nontraditional risk factors, such as chronic volume overload, ane‐ mia, inflammation, oxidant stress, homocysteine and other aspects of the uremic milieu. China collaborative study on dialysis: a multi-centers cohort study on cardiovascular diseases in pa‐ tients on maintenance dialysis showed that cardiovascular morbidity during chronic dialysis was more prevalent in peritoneal dialysis (PD) than HD patients among those with old age and long-term dialysis. Metabolic disturbance-related risk factors were independently associated with CVD only in PD patients. Better understanding the impact of dialysis modality on CVD would be an important step for prevention and treatment [1]. In this chapter we focus on epi‐ demiology and management of traditional and nontraditional CVD risk fators and on ischemic heart disease, heart failure and arrhythmia.