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Effects of dialysate composition during hemodialysis on left ventricular function
J Sztajzel1, P Ruedin, C Stoermann
1Cardiology Center, University Hospital, Geneva, Switzerland.
Kidney International. Supplement
|June 1, 1993
Summary
Acetate-free biofiltration (AFB) better preserves left ventricular diastolic function during hemodialysis compared to acetate (AHD) and bicarbonate (BHD) hemodialysis. AFB shows fewer adverse effects on cardiac function in hemodialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Medical Technology
Background:
- Chronic hemodialysis patients often experience cardiovascular complications.
- Dialysate composition may influence cardiac function during hemodialysis.
- Understanding these effects is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the impact of different dialysate compositions on left ventricular function.
- To compare acetate hemodialysis (AHD), bicarbonate hemodialysis (BHD), and acetate-free biofiltration (AFB).
- To assess effects on systolic and diastolic parameters using Doppler-echocardiography.
Main Methods:
- 12 chronic hemodialysis patients without overt heart disease were studied.
- Doppler-echocardiography was performed before and after AHD, BHD, and AFB.
- Key hemodynamic and cardiac function parameters were analyzed.
Main Results:
- All hemodialysis types reduced body weight comparably.
- AFB showed a trend towards greater blood pressure reduction compared to AHD and BHD.
- AFB preserved left ventricular diastolic function (peak E, TP/2, E-area) significantly better than AHD and BHD.
Conclusions:
- Acetate-free biofiltration (AFB) appears to be superior in maintaining left ventricular diastolic function during hemodialysis.
- AHD and BHD may induce transient diastolic dysfunction.
- AFB may offer a safer alternative for hemodialysis patients with cardiac concerns.