Key result
Medical therapy for ischemic heart disease in patients with chronic kidney disease is generally similar to other groups, but surgical revascularization carries a higher risk of complications.
Medical management of heart failure and ischemic heart disease in CKD patients is similar to the general population, though surgical revascularization carries higher complication risks.
Cardiovascular disease (CVD) is a major contributor to the mortality and morbidity of patients who suffer from chronic kidney disease (CKD). Heart failure and ischemic heart disease (IHD) are both highly prevalent in this population. The diagnosis of myocardial dysfunction is usually based on echocardiography. As in the general population, systolic dysfunction is treated with a combination of diuretics, renin-angiotensin system blockade, and beta-receptor antagonists. Diastolic dysfunction is best managed by eliminating the cause. Non-invasive tests for coronary artery disease (CAD) may be less reliable in patients with renal disease compared with nonuremic patients. Medical therapy of IHD in this population is generally similar to that for other patient groups, but surgical revascularization appears to carry a higher risk of complications with poorer clinical outcomes. The choice of revascularization procedure (coronary artery bypass grafting versus percutaneous transluminal angioplasty) should be based on the specific coronary anatomy of a given patient as well as a consideration of other comorbid factors.
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S. Murphy (2003) conducted a review in Chronic kidney disease with cardiovascular disease. Cardiovascular disease management was evaluated. Medical therapy for ischemic heart disease in patients with chronic kidney disease is generally similar to other groups, but surgical revascularization carries a higher risk of complications.
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