CIN '2007 - 4o CONGRESSO DE NEFROLOGIA NA INTERNET
Inadequate Treatment of Congestive Heart Failure in Dialysis Patients
François Madore, MD, MSC
Clinical research Hôpital du Sacré-Coeur de Montréal, Montréal, Québec
Abstract
CHF is present in more than one-third of new dialysis patients and incidence of CHF is reported to be 71/1,000 person-years, a figure that is substantially greater than the reported incidence of acute coronary syndromes (29/1,000 person-years) in ESRD patients (based on data from the USRDS Morbidity and Mortality Study Wave II) . In a recent paper, Banerjee et al. conducted a retrospective analysis of patients who started hemodialysis between 1977 and 1989. Data from the USRDS were analyzed on 1,119,808 incident hemodialysis patients . During the study period, 310,456 patients were identified with a diagnosis of CHF, corresponding to a global incidence of CHF of more than 27% . Thus, approximately one third of ESRD patients on dialysis suffer from CHF.Comments:
- excellent article, however, it's a big point that neither ACEIs nor beta-blockers have been proven via good prospective study to work in heart failure in ESRD.ESRD is so different from the general population, it's been hard or impossible to show that cholesterol control or even hypertension control is beneficial; it would not be shocking to eventually find out that beta blockers and ACEIs are of no great benefit
Sheldon Hirsch
- Estados Unidos da América - Un buen punto, creo que la insuficiencia cardiaca congestiva en el paciente renal con tratamiento de hemodiálisis, debe ser tratada con ultrafiltración estricta, un peso seco ajustado cada sesión y el apoyo con IECAs, entonces podremos controlar y reducir los eventos de falla cardiaca congestiva
Luis Antonio Bermudez Aceves
centro integral de nefrología hospital ángeles Santelena - México