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Published on: November 26, 2018
Right ventricular dysfunction in patients with end-stage renal disease
Francesco Paneni1, Mario Gregori, Giuseppino Massimo Ciavarella
1Division of Cardiology, 2nd Faculty of Medicine, University of Rome 'Sapienza', Sant'Andrea Hospital, Rome, Italy.
American Journal of Nephrology
|October 1, 2010
Summary
Hemodialysis (HD) increases the risk of right ventricular dysfunction (RVD) more than peritoneal dialysis (PD), especially with brachial arteriovenous fistulas. Tissue Doppler imaging (TDI) can detect early RVD in HD patients.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- Right ventricular dysfunction (RVD) is a significant cause of mortality in end-stage renal disease patients.
- Chronic dialysis treatments may elevate pulmonary pressure, potentially impacting right ventricular function.
Purpose of the Study:
- To investigate the impact of different dialysis modalities on right ventricular function.
- To compare right ventricular function between peritoneal dialysis (PD) and hemodialysis (HD) patients.
Main Methods:
- Echocardiography with tissue Doppler imaging (TDI) of the right ventricle was performed on 220 subjects.
- Subjects included healthy controls, PD patients, and HD patients with radial or brachial arteriovenous fistulas (AVFs).
Main Results:
- Pulmonary pressure increased progressively across control and dialysis groups (PD, HD with radial AVF, HD with brachial AVF).
- Right ventricular function, assessed by TDI, was more impaired in HD patients, particularly those with brachial AVFs.
- RVD prevalence was significantly higher in HD patients compared to PD patients and increased further with brachial AVFs versus radial access.
Conclusions:
- Hemodialysis (HD) is associated with a higher risk of right ventricular dysfunction (RVD) compared to peritoneal dialysis (PD).
- The presence of a brachial arteriovenous fistula (AVF) exacerbates RVD risk in HD patients.
- Tissue Doppler imaging (TDI) is a valuable tool for early detection of right ventricular functional impairment in HD patients.
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