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Classical findings on examination include an abnormally sustained, enlarged or displaced apical impulse and an S 4 gallop suggesting left ventricular hypertrophy 3. Heidenheim PA, Muirhead N, Moist L, Lindsay RM. Patient quality of life on quotidian hemodialysis. Am J Kidney Dis. 2003;42(S1)(S1):S36-S41. Home hemodialysis (HHD) offers clinicians an opportunity to provide treatments that are uniquely tailored to the individual needs of each patient, taking into consideration their specific clinical and lifestyle needs.

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Pauly RP, Gill JS, Rose CL, et al. Survival among nocturnal home haemodialysis patients compared to kidney transplant recipients. Nephrol Dial Transplant. 2009;24:2915-2919. Mavrogeni S, Katsi V, Vartela V et al. The Emerging Role of Cardiovascular Magnetic Resonance in the Evaluation of Hypertensive Heart Disease. BMC Cardiovasc Disord. 2017;17(1):132. doi:10.1186/s12872-017-0556-8 - Pubmed Ting GO, Kjellstrand C, Freitas T, Carrie BJ, Zarghamee S. Long-term study of high-comorbidity ESRD patients converted from conventional to short daily hemodialysis. Am J Kidney Dis. 2003;42(5):1020-1035. Kraus MA, Cox CG, Summitt CL, et al. Work and travel in a large Short Daily Hemodialysis (SDHD) program. Abstract presented at American Society of Nephrology Annual Conference, 2007. López B, Castellano JM, González A, Barba J, Díez J. Association of increased plasma cardiotrophin-1 with inappropriate left ventricular mass in essential hypertension. Hypertension 2007;50:977-83.ESRD patients typically experience multiple modalities over the course of their disease, which is why it is important to monitor for signs that their current therapy is no longer meeting their clinical and lifestyle needs. We propose the term hypertensive cardiopathy or hypertensive heart disease to be used to describe a complex and variable syndrome that usually, but not necessarily, includes clinical manifestations derived from: left ventricular hypertrophy and dysfunction, be it diastolic or systolic; myocardial ischemia; and rhythm abnormalities, all of them caused by the effects on the heart of chronically elevated blood pressure. Table 2 depicts the proposed comprehensive classification including those three possibilities of cardiac kinvolvement (Ventricle, Ischemia and Arrhythmia); so, the acronym VIA is proposed as well. Mensah GA, Croft JB, Giles WH. The heart, kidney, and brain as target organs in hypertension. Cardiol Clin 2002;20:225-47. Sustained hypertension causes structural and functional abnormalities of the heart, involving ventricular and atrial myocardium as well as epicardial and intramural coronary arteries. As a result, three different, although obviously related to each other, cardiac diseases in hypertensive patients may be recognized: heart failure, myocardial ischaemia, and atrial fibrillation9-17. These three main cardiac complications of hypertension can take place separately or combined, at different degrees of severity, or in various evolutive stages18.

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Home hemodialysis with the NxStage System during the day may not require a care partner, provided a physician and a qualified patient agree that solo home hemodialysis is appropriate. Patients performing nocturnal treatments are required to have a care partner. Care partners are trained on and follow guidelines for proper operation. If you choose to do more frequent home hemodialysis, you will be responsible for complying with your dialysis prescription, which may require treatments up to six days per week. Kuruvilla S, Janardhanan R, Antkowiak P et al. Increased Extracellular Volume and Altered Mechanics Are Associated With LVH In Hypertensive Heart Disease, Not Hypertension Alone. JACC Cardiovasc Imaging. 2015;8(2):172-80. doi:10.1016/j.jcmg.2014.09.020 - PubmedBhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al; the REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006;295:180-9. U.S. Renal Data System, USRDS 2015 Annual Data Report: Table 6.3. Adjusted survival (%) by (a) treatment modality and incident cohort year (year of ESRD onset), and (b) age, sex, race, and primary cause of ESRD, for ESRD patients in the 2008 incident cohort (initiating ESRD treatment in 2008) Abbreviation: ESRD, end-stage renal disease.