Cardiovascular screening in kidney disease

Guideline Organization

Recommendation (Evidence Level)

Evidence

Comments

CARI-Guidelines
2003

- Attention to contributory factors should be addressed before the patient reaches ESRF (Levels I & II): reversal of anaemia, reduction of plasma volume, control of hypertension, use of ACE-inhibitor, control of hyperparathyroidism. (Levels III & IV)

3. Hypertension, LVH.

CSN-Canada

EBPG-Europe
2002

- Patients cardiovascular risk should be assessed and documented at the onset of haemodialysis and 6 monthly thereafter. Risk assessment includes modifiable risk factors such as cigarette smoking, hyperglycaemi-a, dyslipidaemia and hypertension.

Guideline VII.1 Assessment of cardiovascular risk factors

KDOQI-US
2004

- At the initiation of dialysis, all patients regardless of symptoms, require assessment for cardiovascular disease as well as screening for both traditional and non traditional factors (Level C)
- Echocardiogram should be performed in all patients at the initiation of dialysis once they achieved dry weight (ideally within 1-3 months) (Level A) and 3 yearly intervals thereafter (Level B – Rationale: see Guideline 6)

Guidelines on initiation and management of cardiovascular diseases

Guideline 1 Evaluation of cardiovascular disease in adult and pediatric patients

UK-Guidelines
2007

- Patients with CKD should have an annual formal assessment of their cardiovascular risk factors including measurement of HDL and total cholesterol, BMI, exercise, alcohol and smoking habits as well as a review of interventions to reduce cardiovascular risk (good practice)

CKD - Section 2: Treatment of Patients with CKD