Ischemic heart disease in patients with end-stage chronic kidney disease: pathophysiological features and surgical treatment

Patients with chronic kidney disease have high risk of cardiovascular diseases, while patients with end-stage chronic kidney disease, initially on dialysis, whom myocardial revascularization is recommended, represent a separate, more severe group of patients with their own clinical and pathophysiological features. Myocardial revascularization is indicated for patients in the terminal stage of kidney disease, but the risk of death and the development of intra- and postoperative complications is higher. Despite the significant achievements of endovascular surgery, coronary artery bypass grafting is the preferred method of the surgical treatment of coronary heart disease in this category of patients, demonstrating more evidence-based long-term results. In this clinical case, the pathophysiological features of coronary heart disease in the patient with end-stage chronic kidney disease are reflected and the effectiveness of coronary artery bypass grafting in the treatment of coronary heart disease in the patient, who needs dialysis.