Heart Disease in Dialysis Patients

Cardiac disease is the major cause of death in dialysis patients, accounting for half of the total mortality. Clinical manifestations (morbidity of cardiac disease) are equally high. When routinely assessed by echocardiography, the proportion of patients with abnormal dimensions of cardiac compart-ments is still higher. It should be remarked that this also applies to patients with chronic renal disease. In other words the sanne pathogenetic mecha-nisms are present before the start of dialysis treatment. Many patients entering dialysis programs have severe damage already and the complica-tions seen during HD treatment are the result of an ongoing process. Unfortunately, some authors consider it as inexorable fate and speak about the natural history of cardiac disease in dialysis patients. This suggests that the development is the result of sonne intrinsic cardiac process, while in reality its course is mainly determined by extrinsic factors, i.e. the way of treatment. Dialysis provides a unique opportunity to correct some of these pathogenetic mechanisms and thus slow down, improve, or even cure complications, which once were considered inevitable.