Cause and management of heart failure in patients with chronic renal disease.

Heart failure occurs in 40% of patients with end-stage renal disease and is a major determinant of mortality. Heart failure occurs in patients with left ventricular systolic dysfunction (dilated left ventricle) as well as those with a normal resting ejection fraction (nondilated left ventricle). This report describes the cause of heart failure among patients with end-stage renal disease and the effect of heart failure on survival. We also discuss the impact of renal failure on the medical management of these patients.