ISCHEMIC-HEART-DISEASE IN CHRONIC UREMIA

The burden of ischemic heart disease is high in dialysis patients. Isc hemia may result from atherosclerotic and nonatherosclerotic disease a nd may cause myocardial infarction and angina. The impact of diminishe d perfusion is intricately associated with the underlying cardiomyopat hy, both of which predispose to heart failure. The etiology of ischemi a is complex and associated with the underlying cardiomyopathy, whethe r it be concentric left ventricular hypertrophy, left ventricular dila tation, or systolic dysfunction. Hypertension, diabetes, dyslipidemia, abnormalities of divalent ion metabolism, hypoalbuminemia, and left v entricular hypertrophy are probably adverse risk factors for ischemia, but the relative importance of each is unknown.