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A Murine Model of Hemodialysis Access-Related Hand Dysfunction

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Changes in left ventricular diastolic function during hemodialysis sessions.

Solmaz Assa¹, Yoran M Hummel, Adriaan A Voors

¹Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation

|April 4, 2013

Summary

This summary is machine-generated.

Left ventricular diastolic function deteriorates early in hemodialysis sessions. This worsening of diastolic function, indicated by decreased mitral inflow (E) and early diastolic velocity (mean e'), is not solely explained by blood volume changes.

Keywords:

Blood volume cardiovascular disease diastolic function hemodialysis

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Area of Science:

Cardiology
Nephrology
Medical Imaging

Background:

Left ventricular diastolic dysfunction is prevalent in hemodialysis patients, correlating with adverse outcomes.
Previous research indicated worsening diastolic function post-hemodialysis, but changes during the session remained unexamined.

Purpose of the Study:

To investigate the temporal evolution of left ventricular diastolic function parameters during a hemodialysis session.
To assess early and late changes in diastolic function within the hemodialysis procedure.

Main Methods:

An observational study involving 109 hemodialysis patients.
Echocardiography was used to measure mitral inflow (E) and mean early diastolic tissue Doppler velocity (mean e') at predialysis, 60 minutes, 180 minutes, and postdialysis.
Relative blood volume changes were monitored via hematocrit.

Main Results:

Diastolic function parameters, E and mean e', significantly decreased during hemodialysis (P < 0.001).
The most substantial decline occurred within the first 60 minutes of dialysis.
Early changes in E correlated with relative blood volume and brain natriuretic peptide levels, but mean e' changes did not.

Conclusions:

Left ventricular diastolic function declines early in hemodialysis sessions.
The decrease in mean e' at 60 minutes was not fully explained by relative blood volume changes, suggesting potential non-volume-related mechanisms.
Limitations in measuring relative blood volume highlight the complexity of assessing volume status and its impact on diastolic function during dialysis.