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Published on: November 7, 2017
Improvement in "uremic" cardiomyopathy by persistent ultrafiltration.
Hüseyin Töz1, Mehmet Ozkahya, Filiz Ozerkan
1Nephrology Department, Ege university Medical School, Bornova, Izmir, Turkey. tozhus@superonline.com
Hemodialysis International. International Symposium on Home Hemodialysis
|January 30, 2007
Summary
Persistent slow ultrafiltration (UF) significantly improves cardiac function in end-stage renal disease patients with severe cardiac dilatation. This treatment reduces cardiothoracic index and improves ejection fraction, even in difficult cases.
Area of Science:
- Nephrology
- Cardiology
Background:
- Patients with end-stage renal disease (ESRD) often develop cardiac dilatation and dysfunction.
- These patients may have low ejection fraction (EF), valvular regurgitation, and poor tolerance to standard ultrafiltration (UF).
Purpose of the Study:
- To evaluate the effectiveness of persistent slow ultrafiltration (UF) in improving cardiac function in ESRD patients with severe cardiac dilatation.
- To assess changes in cardiothoracic index, ejection fraction, and valvular regurgitation.
Main Methods:
- Twelve ESRD patients with cardiothoracic index >0.54 and EF <0.45 underwent slow, prolonged UF during hemodialysis sessions.
- Treatment was supplemented with isolated UF sessions as needed.
- Repeated chest X-rays and Doppler echocardiography were used for monitoring.
Main Results:
- All patients achieved edema-free status and lost weight (mean 12+/-10 kg).
- Cardiothoracic index significantly decreased (0.59+/-0.04 to 0.47+/-0.03).
- Ejection fraction improved (0.31+/-0.9 to 0.50+/-0.9), and mitral/tricuspid regurgitation resolved or improved in all patients.
Conclusions:
- Carefully monitored, persistent slow UF can significantly improve cardiac dilatation and dysfunction in ESRD patients.
- This therapeutic approach offers a promising option for patients with seemingly intractable dilated cardiomyopathy.
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