How can dialysis patients prevent cardiovascular disease? These 3 key points must be mastered!

Dialysis patients have severely impaired renal function, and their metabolic waste and excess water cannot be discharged normally. Their bodies are in a complex pathophysiological state for a long time, which greatly increases their risk of cardiovascular disease. Cardiovascular disease has become the leading cause of death in dialysis patients, seriously threatening the life and health of patients. Therefore, it is crucial for dialysis patients to master effective methods to prevent cardiovascular disease. Dialysis patients must keep the following 3 points in mind.

Strictly control blood pressure

1. Importance of blood pressure control: Hypertension is an important risk factor for cardiovascular disease, especially for dialysis patients. The kidneys of dialysis patients cannot regulate blood pressure normally, and factors such as water and sodium retention in the body and imbalance of the renin-angiotensin-aldosterone system (RAAS) can easily lead to high blood pressure. Long-term high blood pressure will increase the burden on the heart, damage the blood vessel walls, accelerate the process of atherosclerosis, and increase the risk of cardiovascular diseases such as coronary heart disease, heart failure, and stroke. Studies have shown that for every 20 mmHg increase in systolic blood pressure in dialysis patients, the risk of death from cardiovascular disease increases by about 50%.

2. Control methods: Dialysis patients should measure their blood pressure regularly, at least 2-3 times a week, to understand their blood pressure changes. Under the guidance of doctors, use antihypertensive drugs reasonably. Common antihypertensive drugs include angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor antagonists (ARB), calcium channel blockers, beta-receptor blockers, etc. These drugs can lower blood pressure and protect the heart and blood vessels through different mechanisms of action. For example, ACEI and ARB can not only lower blood pressure, but also reduce proteinuria and delay the deterioration of renal function; calcium channel blockers can dilate blood vessels and reduce peripheral vascular resistance, thereby lowering blood pressure. At the same time, patients should pay attention to controlling water intake to avoid high blood pressure due to water and sodium retention. Follow the drinking water plan formulated by the doctor. The daily water intake is generally the urine volume of the previous day plus 500 ml. In addition, maintain a low-salt diet, and the daily salt intake should not exceed 5 grams. Reducing sodium intake can help reduce water and sodium retention and stabilize blood pressure.

Actively correct anemia

1. The relationship between anemia and cardiovascular disease: Dialysis patients are often accompanied by anemia, which is due to the decrease in the production of erythropoietin by the kidneys, resulting in insufficient red blood cell production. In addition, factors such as blood loss during dialysis and lack of hematopoietic raw materials such as iron and folic acid can also aggravate anemia. Anemia reduces the blood's ability to carry oxygen, and the heart needs to work harder to meet the body's demand for oxygen, which leads to increased burden on the heart and myocardial hypertrophy. Long-term anemia can also cause insufficient blood supply to the coronary arteries, increasing the risk of arrhythmias and heart failure.

2. Correction method: Dialysis patients should have regular blood tests and monitor hemoglobin levels. Treatment should be carried out under the guidance of a doctor according to the cause and degree of anemia. Common treatment methods include the use of hematopoietic raw materials such as erythropoietin, iron supplements, folic acid and vitamin B12. Erythropoietin can stimulate bone marrow hematopoiesis and increase the production of red blood cells; iron is an important raw material for the production of hemoglobin, and iron deficiency will affect the synthesis of hemoglobin. Therefore, dialysis patients need to supplement enough iron, which can be supplemented orally or intravenously; folic acid and vitamin B12 are involved in the production of red blood cells. When they are deficient, they will also cause anemia and need to be supplemented appropriately. At the same time, patients can eat more foods rich in iron and protein, such as lean meat, fish, eggs, beans, etc., which will help improve anemia.

Reasonable adjustment of blood lipids

1. Hazards of dyslipidemia: Dialysis patients often have dyslipidemia, which is mainly manifested by elevated triglycerides and decreased high-density lipoprotein cholesterol. Dyslipidemia can cause lipids to deposit on the blood vessel walls, forming atherosclerotic plaques, which narrow and harden the blood vessels and increase the risk of cardiovascular disease. These plaques may also rupture, triggering thrombosis, leading to serious cardiovascular events such as acute myocardial infarction and cerebral infarction.

2. Adjustment method: Dialysis patients should have their blood lipids checked regularly, generally every 3-6 months. According to the blood lipid situation, lipid-lowering treatment should be carried out under the guidance of a doctor. For patients with mild abnormal blood lipids, blood lipids can be controlled by diet and lifestyle adjustments. Reduce the intake of saturated fatty acids and cholesterol, avoid eating animal offal, fried foods, cream, etc.; increase the intake of unsaturated fatty acids, such as eating more deep-sea fish, nuts, etc. At the same time, increase the amount of exercise appropriately, and do at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, jogging, swimming, etc., which will help increase the level of high-density lipoprotein cholesterol and lower blood lipids. For patients with severe abnormal blood lipids, lipid-lowering drugs are needed for treatment. Commonly used lipid-lowering drugs include statins, fibrates, etc. Statins mainly lower cholesterol, and fibrates mainly lower triglycerides. Doctors will choose appropriate drugs according to the specific situation of the patient.

The prevention of cardiovascular disease in dialysis patients needs to start from multiple aspects, and strict control of blood pressure, active correction of anemia, and reasonable adjustment of blood lipids are the key points. Patients should actively cooperate with the doctor's treatment, have regular checkups, and maintain good living habits, such as quitting smoking and limiting alcohol, and having a regular work and rest schedule, in order to effectively reduce the risk of cardiovascular disease, improve the quality of life, and prolong life.