Chronic kidney disease (CKD) is a globally recognized public health concern. Multiple studies have shown the association of CKD with cardiovascular mortality that persists after adjustment for traditional cardiovascular disease (CVD) risk factors. CKD causes accelerated coronary artery disease (CAD). In this chapter, we discuss the pathophysiological mechanisms that play a role in increasing CVD risk in patients with CKD. Further we delve into some commonly encountered challenges related to CVD in patients with CKD. These include revascularization challenges, contrasted induced nephropathy and alterations in traditional risk factors for CVD in renal transplant patients.

On-line HDF represents a major technical development in the delivery of hemodialysis therapy: It combines the properties of increased diffusion available in current high-flux membranes with convective removal of between 6 and 30 liters per treatment and requires the use of ultrapure water and online filtration of replacement fluid. On-line HDF has been successfully introduced in Europe and Asia and is routinely prescribed for dialysis patients in these regions.The book at hand summarizes the history and achievements of on-line HDF in four parts: A report of the technological development in both machine and fiber/dialyzer is followed by a description of the challenges encountered in the evolution of on-line HDF, collecting the accounts of clinical key opinion leaders who had been involved in its early application. The third part presents a comprehensive review of the clinical results achieved with on-line HDF from its inception to the present times, in which it represents the clinical golden standard. The fourth and final part is dedicated to on-line HDF as a ‘vision’ for the future.

Extending from the outpatient management of cardiovascular and kidney disease, to hospital-based decision making in patients with cardio-renal disease and complex interfaces such as hemodialysis in patients with ventricular assist device support, this book serves as a single reference point for cardiology and nephrology clinicians and researchers dealing with the significant overlap areas between these two specialties. Chapters cover the physiology, biomarkers, therapeutic agents and full spectrum of these comorbidities and feature separate sections on cardiovascular and CKD evaluations, stratification of kidney transplant patients, lipid management in CKD, interventional strategies and hypertension. Leaders in cardiology, nephrology, hypertension and lipidology bring together the latest evidence with their collective clinical experience into this invaluable resource.This textbook is an essential resource for physicians and allied professionals practicing cardiology, nephrology, students and physician trainees, to deepen their understanding of this crucial field.

Known worldwide, chronic kidney disease (CKD) is a disease that affects up to 4% of the population with increasing figures also in the developing countries. Life expectancy of patients affected by CKD is shortened compared to the overall population, and only a minority of patients reach end-stage renal disease (ESRD) with the need for dialysis or renal transplantation; death overtakes dialysis. In the 13 chapters, this book sheds light on the different aspects related to pathophysiology and clinical aspects of CKD, providing interesting insights into not only inflammation and cardiovascular risk but also the interplay of hormones and the functional aspects of endothelial function. In addition, chapters dealing with genetic aspects of polycystic kidney disease and also the clinical handling of patients with CKD and peritoneal dialysis will be beneficial for the open-minded reader.

Hemodialysis therapy has become a well-established form of renal replacement, and due to continuous improvements in technology, a series of new biomaterials and techniques for the clinical routine have been developed. Nevertheless, cardiovascular disorders in hemodialysis and uremia represent one of the most important aspects of modern nephrological care. This publication is therefore dedicated to cardiovascular risk factors, the role of the endothelium, problems related to mineral disorders and finally to the possible impact of new technologies on the final outcome in hemodialysis. Being a state-of-the-art appraisal of today's technology and current issues in hemodialysis with special regard to cardiovascular disorders and risk factors, this book is a synthesis between an educational effort aimed at the newer generations of physicians and nurses in the field of hemodialysis and a state-of-the-art description of the most advanced technologies in this field. At the same time, the lessons learned from large international trials, either already completed or to be completed in the years to come, are presented.

Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia –related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.

Studies have shown that half of all dialysis patient deaths can be attributed to cardiovascular disease. This book give a comprehensive review of the principal cardiovascular complications in patients with end-stage renal disease. It discusses, causes, diagnosis, treatment and prevention. Increased prevelance of diabetes and vascular disease has made this a topic of extreme importance in nephrology world-wide.