Cardiovascular disease

Cardiovascular disease and dialysis: What you need to know to stay healthy
As you may already know, a large number of dialysis patients are affected by various illnesses of the cardiovascular system. The good news: with the right care and protective measures, there are ways you can actively help slow down the progression of cardiovascular disease and improve your prognosis, or reduce your risk of developing it.

The role of the cardiovascular system
All together, our heart, veins, arteries and capillaries are known as the cardiovascular system. The system’s main job is essential to keeping us alive and well: it ensures blood moves from the heart to the lungs, and to the rest of the body to supply it with oxygen. But for people with cardiovascular disease, the body is unable to perform these important tasks as well as it should.

Cardiovascular disease – a closer look
The term cardiovascular disease is actually a misnomer: it is not just one disease, but rather a collective term for a range of diseases including hypertension, atherosclerosis, coronary heart disease and stroke. Some of the conditions occur more frequently than others. Cardiovascular disease can cause a person’s heart to stop pumping blood efficiently, prevent valves from working as they should, or narrow or harden the arteries. Certain toxins or bacteria can also play a role in damaging parts of the heart and blood vessels.

Why dialysis patients are at risk
Having chronic kidney disease puts you at heightened risk of developing cardiovascular disease, which is why it’s so important to care for yourself, go to doctor’s appointments and follow your doctor’s orders. One reason for the increased risk is that diabetes and high blood pressure, two conditions that if uncontrolled can damage the blood vessels, are two of the leading causes of chronic kidney disease. Generally speaking, damage to the kidneys can also cause high blood pressure, a risk factor for cardiovascular disease. Other common complications of chronic kidney disease that can also contribute to cardiovascular diseases include high homocysteine and calcium-phosphate levels as well as anaemia. Because these conditions often go hand-in-hand with kidney disease, it’s especially important for you to follow the treatment plan developed by your doctor.

Hypertension
High blood pressure, or hypertension, is often referred to as ‘the silent killer’. This nickname stems from the fact that many people have high blood pressure without experiencing any symptoms. Two numbers make up a blood pressure reading: the systolic pressure, the first number, which represents the pressure when the heart beats, and the diastolic pressure, the second number, which represents the pressure when the heart is at relaxation phase. In people with high blood pressure, the blood travels through the blood vessels with excess force. Over time, this damages the vessels, putting a person at higher risk for a heart attack or stroke. Your doctor regularly checks your blood pressure to ensure it stays within a normal range, thereby reducing your risk of complications.

Atherosclerosis, coronary heart disease and stroke
In layman’s terms, atherosclerosis is the hardening of the arteries, the blood vessels that carry blood from the heart to the rest of the body. Fatty deposits known as plaque as well as mineral deposits cause the arteries to harden, which decreases the amount of blood flowing to the heart. A heart that lacks blood may cause symptoms such as chest pain or lead to a heart attack. Hardening of the arteries is also the main cause of coronary heart disease, the term for any condition in which blockage or narrowing causes reduced blood flow to the heart. When the brain does not receive enough oxygen or when a blood vessel bursts, a stroke can result, which requires immediate medical attention.

What causes cardiovascular disease?
As with many conditions, causes of cardiovascular disease are multi-fold and can vary from person to person. Some common risk factors include poor diet, obesity, smoking, stress and an inactive lifestyle, which is why healthy lifestyle choices are so important. General recommendations your doctor may make to help you actively lower your risk of developing cardiovascular disease include eating a well-balanced low-sodium diet, losing weight, stopping smoking, getting more exercise and managing stress better. Making these changes can be challenging at first, but doing so is both good for your Cardiovascular system, your kidneys and your overall health and wellbeing.

Treatment for persons with chronic kidney disease
As mentioned before, your nephrologist will regularly monitor and check for signs of cardiovascular disease. This includes measuring your blood pressure and taking a blood sample to check for anaemia. If indications are present, your doctor will develop a personal treatment plan, which may include medications to lower high blood pressure or high cholesterol. Other imbalances or deficiencies that put you at higher risk for cardiovascular disease such as high calcium or phosphate levels will likewise be evaluated and treated. If you also have diabetes, keeping your blood sugar in check is an essential part of protecting your cardiovascular system and kidneys.
Because the foods you eat every day can also have a direct effect on symptoms of cardiovascular disease, your nephrologist will also have you consult with a dietician specialised in renal care. Working together, you’ll develop a delicious yet nutritious eating plan that will help you feel better and keep you in best possible health. Remember: Following your doctor’s and dietician’s recommendations and caring for yourself properly are the nuts and bolts to living well on dialysis and with cardiovascular disease. Doing so is key to improving your personal outcome and increasing your overall quality of life.