Hemodialysis-induced cardiovascular disease

作者：Ahmadmehrabi S, Tang WHW · 发表于：Seminars in dialysis · 年份：2018 · DOI：10.1111/sdi.12694 · 被引用次数：110 · 研究领域：Cardiovascular Diseases、Female、Humans、Incidence、Kidney Failure, Chronic、Male、Prognosis、Renal Dialysis、Risk Assessment

More than half of all deaths among end stage renal disease (ESRD) patients are due to cardiovascular disease (CVD). Cardiovascular changes secondary to renal dysfunction, including fluid overload, uremic cardiomyopathy, secondary hyperparathyroidism, anemia, altered lipid metabolism, and accumulation of gut microbiota-derived uremic toxins like trimethylamine N-oxidase, contribute to the high risk for CVD in the ESRD population. In addition, conventional hemodialysis (HD) itself poses myocardial stress and injury on the already compromised cardiovascular system in uremic patients. This review will provide an overview of cardiovascular changes in chronic kidney disease and ESRD, a description of reported mechanisms for HD-induced myocardial injury, comparison of HD with other treatment modalities in the context of CVD, and possible management strategies.