Heart Failure in a Patient with End-Stage Kidney Disease on Renal Replacement Therapy

  • Shadi Ahmadmehrabi
  • Hernan Rincon-Choles
  • W. H. Wilson TangEmail author


Cardiovascular disease (CVD) remains one of the main causes of death in patients with end-stage kidney disease on renal replacement therapy. Intermittent hemodialysis itself causes significant hemodynamic stress and vascular changes as well as a potential high-output state from arteriovenous fistula that can be linked to left ventricular hypertrophy and myocardial ischemia and stunning. Cardiovascular and metabolic changes such as fluid overload, uremia, secondary hyperparathyroidism, anemia, and dyslipidemia contribute to high CVD risks. Appropriate heart failure and coronary artery disease management (e.g. drugs and devices) as well as metabolic treatment (e.g. anemia) may attenuate disease progression, while modifications in modalities of renal replacement therapy or renal transplant may provide a more favorable cardiovascular profile.


Renal replacement therapy Heart failure End-stage renal disease 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Shadi Ahmadmehrabi
    • 1
  • Hernan Rincon-Choles
    • 2
  • W. H. Wilson Tang
    • 3
    Email author
  1. 1.Cleveland Clinic Lerner College of MedicineCleveland ClinicClevelandUSA
  2. 2.Department of NephrologyGlickman Urological and Kidney Institute, Cleveland ClinicClevelandUSA
  3. 3.Department of Cardiovascular Medicine Cleveland ClinicClevelandUSA

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