Key result
Pharmacotherapy for cardiovascular conditions appears less effective in hemodialysis patients than in the general population or patients with early-stage chronic kidney disease.
Why the study?
Does pharmacotherapy improve cardiovascular outcomes in hemodialysis patients?
Does pharmacotherapy improve cardiovascular outcomes in hemodialysis patients?
Standard cardiovascular pharmacotherapies appear less effective in hemodialysis patients compared to the general population, indicating a need for tailored evidence in this cohort.
Standard CV pharmacotherapy may underperform in hemodialysis patients; leaves open the need for dedicated trials in this population.
Cardiovascular disease (CVD) occurs commonly in patients with chronic kidney disease (CKD) including those treated with hemodialysis (HD), and is associated with poor outcomes in this population. Pharmacologic management of hypertension, dyslipidemia, acute and chronic coronary artery disease, and atrial fibrillation in the general population is supported by the results of high-quality, randomized, controlled clinical trials. Pharmacotherapy of these disorders in the general population is effective in improving clinical outcomes. In contrast, information concerning the effect of pharmacotherapy on mortality and cardiovascular outcomes in patients with CKD, and particularly in HD patients, is limited. Available data suggest that, in general, pharmacotherapy of hypertension and dyslipidemia, anti-platelet therapy of CVD, and anticoagulant therapy in patients with atrial fibrillation are less effective in HD patients than in the general population or even in patients with early stage of CKD.
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Mittal et al. (2015) conducted a review in Chronic kidney disease (CKD) and hemodialysis (HD). Pharmacotherapy (hypertension, dyslipidemia, anti-platelet, anticoagulant) vs. General population or early stage CKD was evaluated on Mortality and cardiovascular outcomes. Pharmacotherapy for cardiovascular conditions appears less effective in hemodialysis patients than in the general population or patients with early-stage chronic kidney disease.
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