World Cardiology and Cardiologist Meeting

Patients with end-stage renal disease requiring dialysis are at increased risk for development of heart failure (HF). Factors that may contribute to HF in the dialysis patient include fluid overload, left ventricular diastolic dysfunction, LV systolic dysfunction,

and valvular heart disease. A high-output state caused by shunting through hemodialysis arteriovenous access can also precipitate HF.

 

A proposed functional classification scheme was developed specifically for patients with end-stage renal disease (ESRD) by the Acute Dialysis Quality Initiative (ADQI) XI Workgroup. The cardiac evaluation of dialysis patients should address whether HF is present, what type of HF is present (HFrEF; LVEF ≤40 percent, HF with midrange ejection fraction HFmrEF; LVEF 41 to 50 percent, HF

with preserved ejection fraction HFpEF; LVEF >50 percent, HF from valve disease, and identification of contributing factors. The approach to management of HF in the dialysis patient varies depending on the clinical presentation.