| [ Summary ] |
The age-associated decrease in glomeruli, and the progression of diabetic nephropathy, nephrosclerosis, or glomerulonephritis to chronic kidney disease (CKD), eventually result in elderly patients requiring dialysis. Patients on dialysis die of heart failure (26.9 %), infection (20.8 %), malignancies (9.4 %), that is, they die of cerebro-vascular diseases (> 40 %). Furthermore, hypertension and atherosclerosis, which are associated with ischemic heart disease, valvular heart disease, and atrial fibrillation, are common in the elderly and in patients on dialysis. Although the suggested mechanisms underlying the frequent cardiovascular complications in dialysis patients include multiple classic risk factors, other non-classic risk factors are also suspected to play a role. Moreover, impaired phosphate excretion and ageing promote vascular calcification, and therefore, may lead to cardiovascular events. |