Occurrence and significance of heart disease in uraemia. An autopsy study

The occurrence of heart disease in uraemic patients was evaluated from study of 94 autopsied cases of chronic renal failure. The most common autopsy-ascertained causes of death were congestive heart failure (37%), acute myocardial infarction (13%) and tamponading pericarditis (8%). Death from congestive heart failure was significantly more common among the patients aged 60 or more than in the younger group. Hypertension was recorded in 59% of the patients, including all those with fatal myocardial infarction. Coronary arteriosclerosis was graded as absent to mild in about 40% of the patients. More severe grades occurred predominantly in the older patients. Tamponading pericarditis almost exclusively affected patients in haemodialysis. The authors conclude that most deaths among patients with end-stage renal failure were due to congestive heart failure. Ischaemic heart disease did not seem to be a more common cause of death than in the general population.