Epidemie van cardiovasculaire ziekten bij patiënten onder chronische hemodialyse; verscherpte aandacht nodig voor volumebelasting

- The very high mortality of patients on chronic haemodialysis treatment is mainly due to cardiovascular complications. Despite the fact that some dialysis centres report much better survival by adhering to the long-known principle of volume control, investigators and advisory committees all over the world define ‘adequate dialysis’ exclusively in terms of removal of ‘toxic factors’. Volume expansion leads to hypertension, cardiac dilatation and cardiac failure through a clear pathophysiological sequence. By giving more responsibility to dialysis nurses patients may be helped to regain their ‘dry weight’.