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May 2020 Br J Cardiol 2020;27(2) doi:10.5837/bjc.2020.010

Cardiac complications in end-stage renal disease: a shared care challenge

Xenophon Kassianides, Adil Hazara, Sunil Bhandari

Abstract

End-stage renal disease (ESRD) represents a state of dysregulation of many processes including inflammation, endothelial dysfunction, vascular calcification, bone mineral metabolism, oxidative stress, autonomic balance, uraemia, volume control, coagulation, insulin resistance, and haematopoiesis. The process of haemodialysis, the most common form of renal replacement therapy, causes myocardial stunning, leading to strain and potential damage,2 and can create a pro-arrhythmic environment.3 The early dialysis period is indeed high risk, with more cardiovascular events reported within the first five months of dialysis.4 It is, therefore, not an

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