Cardiovascular diseases are the leading cause of death in patients on
haemodialysis. Cardiovascular mortality rate in these patients is
approximately 9% per year, with the highest prevalence of left ventricular
hypertrophy, ischemic heart disease and congestive heart failure being the
most frequent cardiovascular complications. Risk factors for cardiac failure
include hypertension, disturbed lipid metabolism, oxidative stress,
microinflammation, hypoalbuminemia, anaemia, hyperhomocysteinemia, and
increased concentration of asymmetric dimethylarginine, increased shunt blood
flow and secondary hyperparathyroidism. Diagnostic strategy for early
detection of patients with increased risk for the development of asymptomatic
disturbances of systolic and diastolic left ventricular function should
include echocardiografic examination, tests for determining coronary vascular
disease, as well as tests of myocardial function (BNP, Nt-proBNP). Early
detection of patients with a high risk of congestive heart failure enables
timely implementation of adequate therapeutic strategy to provide high
survival rate of HD patients.
Heart failure in haemodialysis patients: Evaluation and treatment