Cor Vasa 2010, 52(4):229-233 | DOI: 10.33678/cor.2010.057

Heart failure in patients on dialysis. A review of the issue and proposed therapeutic algorithm

Miloš Kubánek1,*, Marcela Bürgelová2, Tereza Vychodilová2, Jana Vrbská1, Ivan Málek1
1 Klinika kardiologie, Institut klinické a experimentální medicíny, Praha
2 Klinika nefrologie, Institut klinické a experimentální medicíny, Praha, Česká republika

In patients on dialysis, chronic heart failure (CHF) has a high incidence and prevalence and is associated with a very poor prognosis. Chronic renal failure (CRF) worsens the hemodynamic status and myocardial function in patients with an underlying heart disease and may directly contribute to the development of what is called uremic cardiomyopathy. The prognosis of patients with dilated cardiomyopathy and CRF, if treated with carvedilol and angiotensin-coverting enzyme inhibitors, has been shown to improve. In patients with co-existing CHF and CRF, it is imperative to provide, in addition to drug therapy, effective hemodialysis, reduce hyperhydration, and exclude excessive shunt through the arteriovenous fistula. Patients with non-ischemic left ventricular (LV) dysfunction and suspected uremic cardiomyopathy require intensification of hemodialysis; patients with persistent LV dysfunction should be scheduled for renal transplantation leading to normalization of LV systolic function in most cases.

Keywords: Chronic heart failure; Chronic renal failure; Treatment

Published: April 1, 2010  Show citation

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Kubánek M, Bürgelová M, Vychodilová T, Vrbská J, Málek I. Heart failure in patients on dialysis. A review of the issue and proposed therapeutic algorithm. Cor Vasa. 2010;52(4):229-233. doi: 10.33678/cor.2010.057.
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