| [ Summary ] |
Cardiovascular disease (CVD) is a major cause of morbidity and mortality in chronic hemodialysis (HD) patients. Recently, we have admitted more elderly patients and those with diabetes mellitus. Thus, they already have a significant degree of atherosclerosis at the start of HD. They may have multiple risk factors for CVD such as those which are conventional or non-conventional (CKD-related), or HD-related. At this time, there is no method to improve any single treatment for conditions such as anemia, or to produce LDL-cholesterol lowering, or to increase the efficiency or dose for HD. These studies may suggest the complexity of the pathophysiology of HD patients. Of the possible atherosclerosis related risk factors, hypertension is the strongest. However, the target levels pre-HD sessions remain to be developed. The risk of death is similar in patients with a wide range of pre-HD systolic blood pressure levels. It has been shown that patients with hypertension have better nutrition than those with normal or hypotensive levels. Thus, the prognosis is better for those with hypertension. |