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Cardiovascular
mortality is the predominant cause of death in patients with
end-stage renal disease (ESRD). In chronic hemodialysis patients,
approximately 45% of overall mortality is attributable to
cardiac disease, and about 20% of these cardiac deaths are
due to acute myocardial infarction (AMI). The risk of cardiac
and all-cause death is higher in older patients, those with
diabetic nephropathy, and reportedly in patients receiving
peritoneal dialysis. Thus, there is an increasing burden of
cardiac disease in dialysis patients in the United States,
as the greatest increase in ESRD has occurred in older patients
and those with diabetic renal failure. This burgeoning epidemic
of cardiovascular disease in patients with chronic renal failure
has important clinical and financial implications, as the
number of cardiac events and cardiac interventions in this
high-risk group is likely to increase. In 1998, it was estimated
there were approximately 244,000 dialysis patients in the
United States, of whom only 13.5% received peritoneal dialysis.
There were approximately 93,000 patients with renal transplants
in 1998. |
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