Document Detail


Hemodialysis-induced regional left ventricular systolic dysfunction: prevalence, patient and dialysis treatment-related factors, and prognostic significance.
MedLine Citation:
PMID:  22822014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: The hemodialysis procedure may acutely induce regional left ventricular systolic dysfunction. This study evaluated the prevalence, time course, and associated patient- and dialysis-related factors of this entity and its association with outcome.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Hemodialysis patients (105) on a three times per week dialysis schedule were studied between March of 2009 and March of 2010. Echocardiography was performed before dialysis, at 60 and 180 minutes intradialysis, and at 30 minutes postdialysis. Hemodialysis-induced regional left ventricular systolic dysfunction was defined as an increase in wall motion score in more than or equal to two segments.
RESULTS: Hemodialysis-induced regional left ventricular systolic dysfunction occurred in 29 (27%) patients; 17 patients developed regional left ventricular systolic dysfunction 60 minutes after onset of dialysis. Patients with hemodialysis-induced left ventricular systolic dysfunction were more often male, had higher left ventricular mass index, and had worse predialysis left ventricular systolic function (left ventricular ejection fraction). The course of blood volume, BP, heart rate, electrolytes, and acid-base parameters during dialysis did not differ significantly between the two groups. Patients with hemodialysis-induced regional left ventricular systolic dysfunction had a significantly higher mortality after correction for age, sex, dialysis vintage, diabetes, cardiovascular history, ultrafiltration volume, left ventricular mass index, and predialysis wall motion score index.
CONCLUSIONS: Hemodialysis induces regional wall motion abnormalities in a significant proportion of patients, and these changes are independently associated with increased mortality. Hemodialysis-induced regional left ventricular systolic dysfunction occurs early during hemodialysis and is not related to changes in blood volume, electrolytes, and acid-base parameters.
Authors:
Solmaz Assa; Yoran M Hummel; Adriaan A Voors; Johanna Kuipers; Ralf Westerhuis; Paul E de Jong; Casper F M Franssen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-19
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  7     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-08     Completed Date:  2013-03-22     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1615-23     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium
Aged
Chi-Square Distribution
Female
Hemodynamics
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Netherlands / epidemiology
Prevalence
Prognosis
Proportional Hazards Models
Renal Dialysis / adverse effects*,  mortality
Risk Factors
Stroke Volume
Systole*
Time Factors
Ventricular Dysfunction, Left / epidemiology*,  mortality,  physiopathology,  ultrasonography
Ventricular Function, Left*
Comments/Corrections

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