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Cardiovascular changes in chronic hemodialysis patients
Kidney International
|September 1, 1983
Summary
Home dialysis patients often show elevated cardiac index and left ventricular mass, suggesting cardiac changes due to pressure and volume loads, and anemia. These findings are crucial for understanding cardiovascular health in patients undergoing renal replacement therapy.
Area of Science:
- Cardiology
- Nephrology
- Cardiovascular Physiology
Background:
- Patients on maintenance dialysis are at increased risk for cardiovascular complications.
- Understanding the cardiac impact of dialysis is essential for managing patients awaiting renal transplantation.
Purpose of the Study:
- To investigate left ventricular (LV) hemodynamic changes in patients undergoing home dialysis.
- To identify correlations between these changes, duration of dialysis, hypertension treatment, and the presence of coronary artery disease (CAD).
Main Methods:
- Coronary angiography and LV hemodynamic studies were conducted post-dialysis in 32 home dialysis patients.
- A control group of 11 normotensive patients without CAD was included for comparison.
Main Results:
- Ten patients (31%) had significant coronary artery disease (CAD).
- Elevated cardiac index, LV mass, mean aortic pressure, and LV stroke work index were observed in dialysis patients.
- No correlation was found between hemodynamic changes and dialysis duration or hypertension treatment duration.
- Patients with CAD exhibited higher LV mass and mean aortic pressure.
Conclusions:
- Home dialysis patients exhibit significant cardiac alterations, including increased LV mass and elevated cardiac output.
- These changes are likely multifactorial, stemming from pressure/volume overload and anemia.
- The presence of CAD exacerbates cardiac remodeling and hypertension in this population.