Highlights the underutilization of evidence-based heart failure therapies in dialysis patients with systolic dysfunction.
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HF management in dialysis often deviates from nonrenal evidence; leaves open need for dialysis-specific trials before practice change.
Cardiac disease is common in dialysis patients. Survival is poorest in the subgroup with systolic dysfunction (pump failure). Audits show that cardiovascular management of dialysis patients in general, and treatment of congestive heart failure (CHF) specifically, is generally not in agreement with recommendations based on evidence obtained from controlled trials, admittedly in nonrenal patients. The pathophysiology underlying CHF and the rationale underlying interventions are discussed in an effort to heighten awareness of this important clinical problem in the dialysis community.
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Ritz et al. (2002) studied this question.
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