CORONARY-ARTERY DISEASE IN DIALYSIS PATIENTS

Coronary artery disease is a frequent condition in dialysis patients a nd - probably due to the atypical symptomatology - is frequently under diagnosed. Noninvasive tests are of limited value in establishing diag nosis, whereby arteriography is frequently necessary. Secondary prophy laxis is the same as in nondialysis patients. Due to a high reocclusio n rate following PTCA bypass grafting is the preferred therapeutical o ption. When medical therapy is indicated, hemodialysis therapy should be adapted to coexistent coronary artery disease by avoiding dialysis hypotension and overhydration. In coronary patients renal anemia worse ns coronary perfusions and should be treated targeting at least a hema tocrit of 35%.