Ischemic Heart Disease in Patients with End-Stage Kidney Disease.

Abstract:

BACKGROUND:It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. SUMMARY:Recently, 5 different clinical types of acute myocardial infarction (MI) were introduced in the third universal definition of MI. Type 2 MI, known as secondary MI, is a more heterogeneous entity, where a condition other than coronary artery narrowing contributes to an acute imbalance in oxygen supply and demand. In patients with chronic kidney disease, it has been demonstrated that type 2 MI is more common than type 1 MI, which is associated with coronary occlusive disease. It is suspected that patients with ESKD also often have type 2 MI. Factors associated with incremental increases in oxygen demand may cause myocardial ischemia in ESKD. KEY MESSAGES:Significant epicardial coronary narrowing might not be a necessary precursor of myocardial ischemia in ESKD. To prevent ischemic heart disease and improve prognosis in patients with ESKD, we need to pay attention not only to coronary stenotic lesions, but also to the factors associated with the induction of an imbalance in myocardial oxygen supply and demand.

journal_name

Blood Purif

journal_title

Blood purification

authors

Tanaka Y,Joki N,Hase H

doi

10.1159/000441582

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

332-6

issue

4

eissn

0253-5068

issn

1421-9735

pii

000441582

journal_volume

40

pub_type

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