[Dialysis modality and cardiac disease in chronic kidney insufficiency].
In the paper there is presented a problem of usefulness of classical dialysis modalities (peritoneal dialysis--PD and intermittent hemodialysis--HD) in the treatment of end-stage renal disease patients, showing also cardiac disease. Among traditional factors accelerating development of cardiovascular disease, arterial hypertension is more difficult for management in patients treated with PD, especially after loss of residual renal function and deterioration of ultrafiltration capacity of the peritoneum. More atherogenic serum lipid profile and predisposition for thrombosis characterize in greater degree the PD than HD course. Among factors influencing progression of cardiovascular disease, which are connected with chronic kidney disease and dialysis treatment, loss of residual renal function and overhydration differ both modalities of dialysis therapy. Patients treated with PD preserve longer renal function, but predisposition for overhydration is greater in this group as compared to HD patients. An advantage of PD is no need for placement of arterio-venous fistula as well as more stable acid-base balance and kalemia. Relative risk of death in uremic patients with cardiac disease is greater in PD than in HD patients, especially when they suffer from diabetes mellitus. PD is preferred for severe cases of cardiac failure without renal insufficiency or with mild renal insufficiency, leading to improvement of quality of life and decreasing hospitalization rate.
Grzegorzewska
Alicja E
AE
Akademia Medyczna w Poznaniu, Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych. alicja_grzegorzewska@yahoo.com
D002318:Cardiovascular Diseases / Q000150:complications; D006801:Humans; D010530:Peritoneal Dialysis / Q000379:methods*; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*