Options in dialysis therapy: significance of cardiovascular findings.
Most patients receiving renal replacement therapy have cardiovascular disease. The most frequent conditions are left ventricular hypertrophy and coronary artery disease. Hemodialysis is associated with a characteristic spectrum of acute complications (such as hypotension, sudden death) that can be explained by typical dialysis-induced effects on the heart. With continuous ambulatory peritoneal dialysis (CAPD) some of those cardiovascular complications are ameliorated due to slow ultra-filtration and absence of an arteriovenous fistula. It is concluded that CAPD might be the preferable option in patients with cardiovascular disease when hemodialysis can only be performed in a standardized and often aggressive manner. However, achievement of medically-defined goals appears to be more important than technique in dialysis therapy.
Wizemann
V
V
Georg-Haas Dialysis Center, Geissen, Germany.
Timio
M
M
Alpert
M A
MA
Kramer
W
W
D002318:Cardiovascular Diseases / Q000150:complications* / Q000209:etiology; D003327:Coronary Disease / Q000150:complications; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects