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Review Risk factors for coronary artery disease in patients with renal failure. 2003
Prichard S. · Nephrology Division, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada. · Am J Med Sci. · Pubmed #12695726 No free full text.
Abstract: Cardiovascular mortality is markedly increased in patients with end-stage renal disease (ESRD), particularly those receiving dialysis. Coronary artery disease is the most important cause of death in these patients. As in the general population, older age, male gender, and the postmenopausal state in women are cardiovascular risk factors in patients with ESRD. However, hypertension, diabetes mellitus, and dyslipidemia, known to promote cardiovascular disease in the general population, are particularly likely to do so in patients with ESRD because of their high prevalence in this population. In addition, nontraditional cardiovascular risk factors, such as hyperhomocystinemia, inflammation, elevated calcium x phosphate product, endothelial dysfunction, and oxidant stress, occur frequently in patients with ESRD. Vigorous treatment of modifiable cardiovascular risk factors has reduced cardiovascular risk in patients without ESRD. The extent to which such risk factor modification would alter cardiovascular risk in ESRD remains uncertain.
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Article Major and minor risk factors for cardiovascular disease in continuous ambulatory peritoneal dialysis patients. free! 1999
Prichard S. · Department of Medicine, McGill University Health Centre, Royal Victoria Hospital, Montreal, Québec, Canada. · Perit Dial Int. · Pubmed #10406507 links to free full text
Abstract: Uremia in general and peritoneal dialysis in particular bring with them risk factors for the development of cardiovascular disease. These factors include multiple lipid abnormalities, hyperhomocysteinemia, abdominal obesity, chronic inflammation, hypoalbuminemia, oxidative stress, and AGE formation. When these are combined with conventional risk factors, one can appreciate why the incidence of cardiovascular disease is so high in peritoneal dialysis patients. Treatment strategies should address each of these risks appropriately.
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