doiSerbia

Heart failure in haemodialysis patients: Evaluation and treatment

Petrović Dejan (Klinika za urologiju i nefrologiju, Klinički centar „Kragujevac”, Kragujevac)
Miloradović Vladimir (Klinika za internu medicinu, Klinički centar „Kragujevac”, Kragujevac)
Poskurica Mileta (Klinika za urologiju i nefrologiju, Klinički centar „Kragujevac”, Kragujevac)
Stojimirović Biljana (Klinika za urologiju i nefrologiju, Klinički centar Srbije, Beograd)

Cardiovascular diseases are the leading cause of death in patients on haemodialysis. Cardiovascular mortality rate in these patients is approximately 9% per year, with the highest prevalence of left ventricular hypertrophy, ischemic heart disease and congestive heart failure being the most frequent cardiovascular complications. Risk factors for cardiac failure include hypertension, disturbed lipid metabolism, oxidative stress, microinflammation, hypoalbuminemia, anaemia, hyperhomocysteinemia, and increased concentration of asymmetric dimethylarginine, increased shunt blood flow and secondary hyperparathyroidism. Diagnostic strategy for early detection of patients with increased risk for the development of asymptomatic disturbances of systolic and diastolic left ventricular function should include echocardiografic examination, tests for determining coronary vascular disease, as well as tests of myocardial function (BNP, Nt-proBNP). Early detection of patients with a high risk of congestive heart failure enables timely implementation of adequate therapeutic strategy to provide high survival rate of HD patients.

Keywords: heart failure, systolic function disturbances, diastolic function disturbances, haemodialysis, diagnostic strategy