Although hemodialysis is a safe procedure for removing excess waste materials and fluid in kidney failure patients, the leading cause of death in dialysis patients is sudden heart attack.
Heart disease is also called as the cardiovascular disease by professionals. The heart is located between the lungs, in the middle of the chest. It’s an organ that pumps blood and helps in the Transport of nutrients, oxygen, and hormones to cells throughout the body. When the heart is diseased there will be an irregularity in these functions.
Heart diseases are the most common cause of death in all individual accounting for up to 30% of deaths and up to 45% in CKD patients.
Common heart disease found in Dialysis patients
Arrhythmias:
Irregular heartbeat. Maybe too slow or too fast.
Coronary Artery Disease:
Blockage or narrowing of the blood vessel covering the heart (Coronary artery). A blockage may normally due to the accumulation of cholesterol and plaques in blood vessels. In many patients, coronary artery disease leads to Cardiac arrest / sudden heart attack.
Congestive Heart Failure:
Fluid buildup around the heart causing it to pump inefficiently.
Hypertension (High Blood Pressure):
Occurs when blood passes through the arteries at high pressure causing damage to the walls of arteries that may result in the complication as stroke or heart attack.
What are the major risks of obtaining heart disease in dialysis patients?
Fluid Overload:
Results in more stress to the chambers of the heart causing Left Ventricular hypertrophy, a disease where the pumping mechanism of heart declines.
Anemia:
Anemia is a condition where less amount of red blood cells are present in the blood. This is due to the absence of Erythropoietin, a hormone produced by the kidney which is responsible for generating red blood cells. A diseased kidney cannot produce erythropoietin.
Diabetes:
Diabetes is a condition where excess sugar presents in the bloodstream where these sugars damage the blood vessels causing minor to major heart problems.
Aortic stenosis:
Narrowing of the aortic valve of the heart. Aortic stenosis occurs frequently in dialysis patients.
Hypoalbuminemia:
Is a condition where the level of albumin in blood is abnormally low. Hypoalbuminemia may lead to coronary artery disease and cardiomyopathy in dialysis patients.
Abnormal calcium phosphate homeostasis:
Healthy kidneys keep calcium and phosphorus level in balance and this balance cannot be maintained by diseased kidneys.
Dyslipidemia:
Abnormal levels of cholesterols in the blood.
Hyperhomocysteinemia:
Homocysteine is an amino acid found in blood. Hyperhomocysteinemia is normally found in dialysis patients as there is no excretion of homocysteine in renal failure patients.
Smoking:
Smoking is a powerful risk factor for coronary artery disease in the general population, in hemodialysis patients, and especially in diabetics with ESRD.
Tests to check for proper function of heart:
Echocardiogram:
Shows the movement, size, and shape of heart chambers.
Electrocardiogram:
A graphic record of hearts electrical activity.
Angiogram:
X-ray of arteries of the heart.
Treatment of heart diseases in dialysis patients:
Treating underlying causes like anemia, hypertension, diabetes, dyslipidemia, homocysteinemia, fluid overload, and other risk factors will eventually reduce the deterioration of heart diseases in dialysis patients.
Other treatments include, regular in antihypertensive and other medications, lifestyle changes as in following the renal diet and regular exercise, cessation of smoking etc.
LazyKidney 