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Published on: December 11, 2017

[Efficacy of additional low-dose carvedilol in maintenance hemodialysis patients with asymptomatic left ventricular

Masaru Nakayama1, Atsushi Ishii, Fumihiro Takeguchi

  • 1Division of Cardiology, Kashima Hospital, Kashima-machi Shimokuramochi Aza-nakasawame 22-1, Iwaki, Fukushima 971-8143. ms-nakayama@kashima.jp

Journal of Cardiology
|June 28, 2006
PubMed

Insights

Low-dose carvedilol improved cardiac function in hemodialysis patients with asymptomatic left ventricular systolic dysfunction. This treatment showed benefits in cardiac geometry and neurohormonal status over two years.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Maintenance hemodialysis patients often have asymptomatic left ventricular systolic dysfunction.
  • Left ventricular systolic dysfunction can lead to adverse cardiac remodeling and poor prognosis.
  • Current treatment options for this population require careful consideration due to altered pharmacokinetics.

Purpose of the Study:

  • To evaluate the effects of additional low-dose carvedilol on cardiac function and geometry.
  • To assess changes in brain natriuretic peptide levels as a marker of cardiac strain.
  • To determine the safety and efficacy of carvedilol in this specific patient group over a 2-year period.

Main Methods:

  • A cohort of 13 hemodialysis patients with asymptomatic left ventricular systolic dysfunction received 5 mg of carvedilol during each dialysis session.
  • Echocardiography and brain natriuretic peptide levels were measured at baseline and at 3, 6, 12, and 24 months.
  • Safety was monitored for major complications throughout the study duration.

Main Results:

  • Carvedilol was well-tolerated with no major complications over 24 months.
  • Significant improvements were observed in left ventricular ejection fraction (38% to 49%) and a reduction in left ventricular end-diastolic volume.
  • Brain natriuretic peptide levels decreased significantly after 6 months of treatment.

Conclusions:

  • Low-dose carvedilol demonstrates beneficial effects on cardiac function, geometry, and neurohormonal status in maintenance hemodialysis patients.
  • The findings suggest carvedilol can attenuate pathophysiologic cardiac remodeling in this population.
  • Further research on dosage adjustments and drug level monitoring may be necessary for optimal carvedilol therapy in hemodialysis patients.
Abstract

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