INTRODUCTION The treatment of difficult-to-control hypertension in disadvantaged populations—poor, urban, or ethnically diverse—is a challenge that few individual practitioners or institutions have successfully addressed. This is a public health issue of significant importance, as uncontrolled hypertension leads to increased health care expenditures as well as higher rates of morbidity and mortality. The high prevalence of [...]

As with other patients, the renally impaired should undergo preoperative cardiac assessment to assign risk level prior to surgery or any invasive procedure. In patients with advanced chronic renal failure (glomerular filtration rate <20 ml/min), bleeding time determination should be performed before invasive surgery and if bleeding time is prolonged, desmopressin (l-desamino-8-d-arginine vasopressin) should be [...]

Cardiovascular Disease Cardiovascular disease accounts for about 50% of all deaths in ESRD. This mortality is attributed in part to risks during progressive renal insufficiency. Modifiable risk factors such as smoking, obesity, and insufficient physical inactivity should be addressed and corrected, if possible.