Cardiovascular Disease in End-stage Renal Failure

Abstract A better understanding of the pathophysiology of renal failure coupled with technological advances in dialysis techniques and renal transplantation have greatly improved the prognosis and survival for patients with end-stage renal disease (ESRD). Unfortunately, the advances and success of treatment are limited by a number of extrarenal complications that can cause significant morbidity and mortality. Of these, cardiovascular abnormalities are the most common, with cardiac complications alone accounting for more than 40% of deaths in international registries. The importance of cardiovascular complications has become more apparent in recent years with the increased prevalence of diabetes mellitus and vascular nephropathy and with the general ageing of patients with ESRD. The past decade has witnessed enormous advances in understanding the causes and pathophysiology of cardiovascular disease, and their diagnosis, treatment, and prevention. It is, therefore, of importance for physicians caring for patients with end- stage renal failure to understand the pathogenesis of cardiovascular complications, to become familiar with modern diagnostic tools and techniques, and to recognise and treat these complications. The goal of this text is to provide a comprehensive review of the pathophysiology and clinical manifestations of the principal cardiovascular complications in patients with chronic renal failure. The text is intended to assist nephrologists, cardiologists, and internists who care for these patients. The book includes nineteen chapters and is organised in three parts. The first includes three chapters dealing with the epidemiology of cardiovascular disease in patients with end-sage renal failure. The second comprises eight chapters on the basic pathophysiology and pathobiology of cardiovascular diseases in the setting of end- stage renal failure. The third includes eight chapters focusing on clinical manifestations and diagnosis of cardiovascular disease in patients with end-stage renal failure and their management.