**1. Introduction**

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80 Cardiomyopathies

The care of patients with chronic renal insufficiency continues to be complicated by significant cardiovascular dysfunction causing substantial morbidity and mortality. These patients develop cardiovascular disease that is characterized by left ventricular dysfunction and left ventricular hypertrophy (LVH). It has been demonstrated that patients with chronic renal insufficiency develop elevated levels of cardiotonic steroids (CTS) such as marinobufagenin (MBG) in an effort to promote natriuresis and resolve the volume expansion associated with renal insufficiency and cardiac failure. In this review we will try to elucidate the mechanisms involved in the pathogenesis of uremic cardiomyopathy and the role of CTS in cardiac fibrosis.
