Cardiac Dysfunction in Chronic UremiaPatrick S. Parfrey, John D. Harnett Cardiac disease is the major cause of death in dialysis patients, accounting for over one third of deaths. This book focuses on myocardial function and dysfunction in chronic uremia. It is aimed at practicing and training nephrologists, cardiologists, and internists, and at research workers in the field. We have tried to produce an up-to-date, in-depth review of the subject by inviting experts in clinical epidemiology, pathophysiology, and thera peutics to write the 18 chapters. The book is divided into three sections. The first section comprises five chapters that provide an overview of the burden of illness associated with cardiac disease in end-stage renal disease and a review of clinical epidemi ological aspects of various cardiac diseases that occur in renal patients. The second section discusses abnormalities of left ventricular contractility and mass, and the factors that predispose to both systolic and diastolic disorders. The importance of hypertension, anemia, hyperparathyroidism, hyper lipidemia, and diabetes mellitus in predisposing to these abnormalities is reviewed splendidly by researchers active in these areas. The final section concentrates on therapeutics. Data and opinion on management of congestive heart failure, cardiomyopathy, coronary artery disease, hypertension, and arrhythmias are provided. In editing this book, we have reviewed an extensive literature, but un fortunately we have become more aware that substantial gaps in our knowl edge exist. Insufficient high-quality clinical research has been undertaken xiii xiv Preface regarding the various cardiac diseases that occur in end-stage renal disease. |
Contents
Cardiac disease in the general population | 19 |
The natural history of myocardial disease in dialysis patients | 39 |
Demography epidemiology | 53 |
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abnormalities acetate anemia angina aortic arrhythmias arterial hypertension associated atherosclerosis blood pressure calcification calcium CAPD Cardiac Dysfunction cardiac output Cardiol cardiovascular disease cells chronic renal failure chronic uremia Circulation clinical congestive heart failure contractility coronary artery disease coronary heart disease decrease dialysis patients diastolic digoxin dilated cardiomyopathy dose drug echocardiographic ejection fraction end-stage renal disease Engl erythropoietin ESRD ESRD patients figure Framingham Study Harnett HDL cholesterol hemodialysis hemodialysis patients hemodynamic Hutchins GM hyper hyperparathyroidism hypotension increased inhibitors ischemic heart disease Kannel WB Kidney Int left ventricle left ventricular function left ventricular hypertrophy lesions levels lipid lipoprotein LV hypertrophy Massry SG metabolism mitral mortality myocardial infarction myocardium myocytes normal Parfrey patients with ESRD patients with renal peritoneal dialysis pharmacokinetics Pharmacol plasma prevalence rats reduced risk factors role serum significant sodium therapy triglyceride ultrafiltration Unch uremia uremic patients valve vascular verapamil VLDL volume