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Comparison of myocardial perfusion during hemodialysis and hemodiafiltration

Roger De Andrade1, Tessa Kotze, Maia Lesosky

  • 1Division of Nephrology and Hypertension, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.

Nephron. Clinical Practice
|April 30, 2014
PubMed

Insights

Hemodiafiltration (HDF) showed no advantage over hemodialysis (HD) in improving myocardial perfusion defects. Both treatments demonstrated a trend towards worsening perfusion during dialysis sessions.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Imaging

Background:

  • Patients undergoing renal replacement therapy often experience cardiovascular complications.
  • Myocardial perfusion abnormalities are common in patients on hemodialysis.

Purpose of the Study:

  • To compare myocardial perfusion in patients undergoing conventional hemodialysis (HD) versus hemodiafiltration (HDF).

Main Methods:

  • Myocardial perfusion scintigraphy using (99m)Tc-methoxyisobutylisonitrile was performed pre- and post-dialysis in 25 patients.
  • Patients were initially on HD, then switched to HDF for 3 months before repeat scintigraphy.
  • Clinical and laboratory data were collected throughout the study.

Main Results:

  • No statistically significant difference in myocardial perfusion defects was observed between HD and HDF.
  • Both HD and HDF showed a trend towards worsening perfusion defects during dialysis.
  • No significant differences in blood pressure changes were noted between the two methods.

Conclusions:

  • Hemodiafiltration does not offer a statistical advantage over hemodialysis regarding myocardial perfusion defects.
  • The study suggests potential microcirculatory issues contributing to perfusion defects.
  • Further investigation into the pathogenesis of these defects is warranted.
Abstract

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