**4.4. Chronic degenerative diseases (CDD)**

*• Diabetes*

There is a close relationship between HD patients and diabetes, with the incidence of IE.

There are studies that have an incidence of 33–59.4% of patients having statistical significance compared with HD patients with DM without IE, *p* < 0.001 [15, 16].

*• Systemic hypertension*

This condition is related to ESRD patients with HD and IE having an incidence of up 89.9% [15].

*• Coronary artery disease (CAD)*

Kamalakannan et al. in their study with 69 patients showed an incidence of 24.6% of CAD in HD patients with IE. Chou et al. found *p* < 0.001 between HD patients with IE versus the HD patient without IE. This disease is considered to be a potential cause of death in the short and long term in these patients [8, 15, 16].

*• Congestive heart failure (CHF)*

Kamalakannan et al. in their study with 69 patients showed an incidence of 18.8% of CHF in this group of patients. Chou et al. compared CHF in HD patients with IE versus HD patients without IE and found significant differences *p* < 0.001, being the HD patients with IE, the group with more CHF, which also indicates the direct cause of death in these patients in the short term [8, 15, 16].
