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Left ventricular growth after 1 year of haemodialysis does not correlate with arteriovenous access flow: a

Swapnil Hiremath1, Steve P Doucette, Robert Richardson

  • 1Division of Nephrology, Kidney Research Centre, Ottawa Health Research Institute, Ottawa, Ontario, Canada.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 27, 2010
PubMed

Insights

Arteriovenous (AV) access flow in hemodialysis (HD) patients does not correlate with increased left ventricular mass (LVM) or N-terminal pro-brain natriuretic peptide (NT-proBNP) levels after one year. This finding suggests AV access flow is not a primary driver of heart failure risk in HD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Access

Background:

  • Congestive heart failure (CHF) is significantly more common in hemodialysis (HD) patients than acute coronary syndrome.
  • The role of arteriovenous (AV) access blood flow in the development of left ventricular mass (LVM) and subsequent CHF risk in HD patients requires clarification.

Purpose of the Study:

  • To investigate whether blood flow through an AV access contributes to increased LVM in HD patients.
  • To assess the relationship between AV access flow and changes in LVM and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels.

Main Methods:

  • A 1-year prospective cohort study involving HD patients at high risk for CHF.
  • Echocardiography and plasma NT-proBNP levels were measured pre- and post-AV access creation.
  • AV access blood flow was measured, and data were analyzed using statistical methods including correlation and regression.

Main Results:

  • One year after AV access creation, LVM increased by 12.2% (P=0.025) and NT-proBNP levels increased by 170% (P=0.02).
  • No significant correlation was found between average AV access blood flow and the increase in LVM or NT-proBNP levels.

Conclusions:

  • In patients undergoing chronic HD, AV access flow does not correlate with increases in LVM or NT-proBNP levels after one year.
  • These findings suggest that AV access flow is not a direct contributor to the observed changes in cardiac structure and biomarkers related to heart failure in this population.
Abstract

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