Antihypertensive medications and risk of death and hospitalizations in US hemodialysis patients: Evidence from a cohort study to inform hypertension treatment practices.

Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity and mortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes in US hemodialysis patients.We used 2 datasets for our analysis.

Kidney disease in cardiology.

Topics covered in this review include the relation of estimated glomerular filtration rate, proteinuria and outcome; sudden cardiac death; contrast-induced acute kidney injury (CI-AKI); imaging; clinical trials targeting cardiovascular disease in chronic kidney disease (CKD) patients; and treatment of ischemic heart disease and valvular disease. Several studies reinforce the importance of CKD in predicting mortality and make a case for redefining CKD to incorporate levels of proteinuria in the staging system. Another study provides support for using a combination of echocardiography and cardiac biomarkers for cardiac risk stratification in dialysis patients.

Sudden cardiac death and dialysis patients.

Dialysis patients have extraordinarily high mortality rates. The death rate for all US dialysis patients in 2004 was 230 per 1000 patient-years. Cardiac disease is the major cause of death in dialysis patients and accounts for 43% of all-cause mortality.

Cause-specific mortality of dialysis patients after coronary revascularization: why don't dialysis patients have better survival after coronary intervention?

Introduction: The risk of death after coronary revascularization is markedly higher for dialysis patients than for the general population and the cause is inadequately explained. We analyzed cause-specific mortality of dialysis patients after coronary revascularization.

Methods: This was a retrospective analysis of dialysis patients hospitalized for first surgical coronary revascularization after renal replacement therapy initiation from 1 January 1999 to 31 December 2002.

Clinical characteristics of dialysis patients with acute myocardial infarction in the United States: a collaborative project of the United States Renal Data System and the National Registry of Myocardial Infarction.

Background: Acute myocardial infarction (AMI) is catastrophic for dialysis patients. This study set out to determine the clinical characteristics of dialysis patients hospitalized for AMI in the United States.

Methods And Results: This retrospective cohort study used data from the US Renal Data System (USRDS) database (n=1,285,177) and the third National Registry of Myocardial Infarction (NRMI 3) (n=537,444).

Sudden cardiac death and acute myocardial infarction in dialysis patients: perspectives of a cardiologist.

Chronic renal failure is characterized by an increased risk for cardiovascular morbidity and mortality, including acute myocardial infarction (AMI). AMI is associated with poor long-term survival in dialysis patients; the 2-year survival rate of 25% has remained unchanged over the past 2 decades. Although underuse of appropriate therapies likely contributes to adverse outcomes, recent data suggest that dialysis patients with AMI are more likely to have clinical presentations atypical for acute coronary syndrome.

Long-term outcome of renal transplant recipients in the United States after coronary revascularization procedures.

Background: Retrospective studies in dialysis patients have reported increased survival after coronary artery bypass (CAB) compared with coronary artery stenting and PTCA. The purpose of this study was to compare the long-term outcome of renal transplant recipients after stent, PTCA, or CAB with or without internal mammary grafting (CAB [IMG+] or CAB [IMG-]).

Methods And Results: Renal transplant recipients hospitalized from 1995 to 1999 for first coronary revascularization procedure were retrospectively identified from the United States Renal Data System database.

Smoking and cardiovascular outcomes in dialysis patients: the United States Renal Data System Wave 2 study.

Background: Smoking has received surprisingly little research attention in dialysis populations, a group at monumental cardiovascular risk.

Methods: Medicare claims data were used to study associations between smoking and new-onset cardiovascular outcomes, and death in the prospective, inception Wave 2 cohort (N = 4024), assembled in 1996 and 1997.

Results: Of the participants, 56.

Comparative survival of dialysis patients in the United States after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery and impact of diabetes.

Background: The optimal method of coronary revascularization in dialysis patients is controversial. The purpose of this study was to compare the long-term survival of dialysis patients in the United States after PTCA, coronary stenting, or CABG.

Methods And Results: Dialysis patients hospitalized from 1995 to 1998 for first coronary revascularization procedures after renal replacement therapy initiation were identified from the US Renal Data System database.

Blood pressure and long-term mortality in United States hemodialysis patients: USRDS Waves 3 and 4 Study.

Background: The long-term prognostic associations of pre- and post-dialysis blood pressures, interdialytic weight gain, and antihypertensive use in hemodialysis patients are unclear.

Methods: The United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Waves 3 and 4 Study, a randomly generated sample of 11,142 subjects receiving hemodialysis on December 31, 1993, was examined, with vital status followed until May 2000.

Results: Pre- and post-dialysis blood pressure values, interdialytic weight gain and number of antihypertensives averaged 151.

Cardiovascular disease in pediatric chronic dialysis patients.

Background: Little information is available regarding cardiac morbidity and mortality in children with end-stage renal disease. We sought to determine the incidence of cardiac morbidity and mortality in pediatric chronic dialysis patients.

Methods: Medicare incident pediatric (0 to 19 years) dialysis patients from 1991 to 1996 were identified from the United States Renal Data System.

Long-term survival of dialysis patients in the United States with prosthetic heart valves: should ACC/AHA practice guidelines on valve selection be modified?

Background: Minimal data exist on the long-term survival of dialysis patients after cardiac valve surgery. Current practice guidelines of the American College of Cardiology/American Heart Association Task Force on the management of patients with valvular heart disease proscribe the use of bioprosthetic (tissue) valves in hemodialysis patients.

Methods And Results: Dialysis patients hospitalized for heart valve replacement surgery from 1978 to 1998 were retrospectively identified from the US Renal Data System database.