Document Detail

Cardiac depressant factors in renal disease.
MedLine Citation:
PMID:  8387405     Owner:  NLM     Status:  MEDLINE    
Chronic (CRF) and acute renal failure (ARF) are accompanied by cardiac dysfunction, particularly if ARF is complicated by sepsis. Intermyocardiocytic fibrosis is described in CRF, but there is also evidence for functional cardiomyopathy. Acetate ion (present in the dialysate) and secondary hyperparathyroidism do not appear to be clinically relevant myocardial depressant factors in uremia. The role of carnitine deficiency is not clarified, because most of the data are evaluated in poorly controlled study trials. Multiple effects of serum fractions and ultrafiltrates obtained from CRF and ARF patients during dialysis suggest the existence of myocardial depressant factor(s). Beneficial effects of continuous hemofiltration in multiorgan failure give evidence for the pathogenetic role of this substance(s). One group of experiments suggests a molecular weight between 500 and 5,000 d; other experiments suggest activity at > 10,000 d. It is currently believed that myocardial depressant substance is a water-soluble molecule weighing 10,000-30,000 d. The data confirm the existence of "specific cardiomyopathy" caused by a functional defect related to filterable toxins. There are different myocardial depressant factors in CRF, ARF, and sepsis.
W H Hörl; W Riegel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Circulation     Volume:  87     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-06-10     Completed Date:  1993-06-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  IV77-82     Citation Subset:  AIM; IM    
Department of Internal Medicine, University of Saarland, Homburg, FRG.
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MeSH Terms
Acetates / metabolism
Cardiomyopathies / etiology
Heart / physiopathology*
Kidney Diseases / physiopathology*
Kidney Failure, Chronic / complications
Multiple Organ Failure / etiology
Myocardium / metabolism
Parathyroid Hormone / physiology
Receptors, Adrenergic, beta / physiology
Renal Dialysis
Uremia / blood,  therapy
Reg. No./Substance:
0/Acetates; 0/Ions; 0/Parathyroid Hormone; 0/Receptors, Adrenergic, beta

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