Management of coronary artery disease in end-stage renal disease.

Journal Article (Review)

Despite a substantial number of patients with end-stage renal disease who have coronary artery disease, the comparative effectiveness of revascularization procedures such as coronary artery bypass grafting and percutaneous coronary intervention remain unclear. Innovations in the field of coronary artery revascularization and concomitant changes in the standard of practice have improved outcomes in general. However, meaningful clinical decision-making remains difficult because it requires clinicians to extrapolate evidence derived from studies in the general population to patients with kidney disease for whom there is limited information from intervention trials. In non-randomized studies, this high-risk population for cardiovascular morbidity and mortality appear to derive substantial benefits from coronary revascularization. However, specific treatment decisions are often made based upon individual circumstances and contexts that are not well captured in these studies. This article reviews the available evidence, and its limitations, for deciding between various revascularization strategies for patients with end-stage renal disease. Several considerations that arise while making such decisions are discussed.

Full Text

Duke Authors

Cited Authors

  • Roberts, JK; Patel, UD

Published Date

  • September 2011

Published In

Volume / Issue

  • 24 / 5

Start / End Page

  • 525 - 532

PubMed ID

  • 21906164

Electronic International Standard Serial Number (EISSN)

  • 1525-139X

Digital Object Identifier (DOI)

  • 10.1111/j.1525-139X.2011.00948.x

Language

  • eng

Conference Location

  • United States