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Chronic Heart Disease in End Stage Renal Disease (ESRD) on Dialysis

2012-11-19 16:33

Cardiovascular disease is one of common death causes among end stage renal disease (ESRD) patients on dialysis. Chronic heart disease is mainly attributable to the following causes.

Volume overload between dialyses

In ESRD, the patients produce less urine or even no urine at all, which can lead to water retention. Excessive fluids in body can be removed during dialysis sessions by ultrafiltration. However, dialysis is usually done only 2~3 times per week. Between dialysis sessions, water in body will accumulate and fluctuate. This fluctuation can cause left ventricular hypertrophy and then lead to chronic heart disease.


Anemia commonly occurs in ESRD mainly due to decreased synthesis of erythropoietin. In chronic anemia, long-lasting volume overload and increased cardiac work can lead to progressive cardiac enlargement and to the left ventricular hypertrophy. Meanwhile, treatment of anemia with erythropoietin alters both the function and the structure of the left ventricle, thus decreasing the stroke volume and heart rate and decreasing the cardiac output and left ventricular work. These factors can attribute to chronic heart failure in ESRD patients on dialysis.

High blood pressure

Chronic kidney disease could be both the reason and the result of high blood pressure. The ill effects are usually attributed to the reduction in the internal diameter of arteries, resulting in a peripheral resistance increase. As a result, it can reduce blood supply to heart, which is also an attributable factor of chronic heart failure.

Valvular disease

Valvular calcification are typical for ESRD patients. It is an important predictor of all-cause and cardiovascular mortality in people on peritoneal dialysis.

The above are the major attributable factors of chronic heart failure in people on dialysis. If you are unsure the cause of the condition in your case, you should go to see a doctor immediately to find its causes and receive individualized treatment.

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