title: Does pharmacotherapy improve cardiovascular outcomes in hemodialysis patients?
abstract: Cardiovascular disease (CVD) occurs commonly in patients with chronic kidney disease (CKD) including those treated with hemodialysis (HD), and is associated with poor outcomes in this population. Pharmacologic management of hypertension, dyslipidemia, acute and chronic coronary artery disease, and atrial fibrillation in the general population is supported by the results of high-quality, randomized, controlled clinical trials. Pharmacotherapy of these disorders in the general population is effective in improving clinical outcomes. In contrast, information concerning the effect of pharmacotherapy on mortality and cardiovascular outcomes in patients with CKD, and particularly in HD patients, is limited. Available data suggest that, in general, pharmacotherapy of hypertension and dyslipidemia, anti-platelet therapy of CVD, and anticoagulant therapy in patients with atrial fibrillation are less effective in HD patients than in the general population or even in patients with early stage of CKD.
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Mayank
authors.initials: M
authors.lastname: Mittal
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Kul
authors.initials: K
authors.lastname: Aggarwal
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Littrell
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Harsh
authors.initials: H
authors.lastname: Agrawal
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Alpert
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications*
keywords: Cardiovascular disease; anti-platelet therapy; anticoagulation; dyslipidemia; hemodialysis; hypertension