Right ventricular dysfunction in patients with end-stage renal disease.

Abstract:

BACKGROUND:While chronic dialysis treatment has been suggested to increase pulmonary pressure values, right ventricular dysfunction (RVD) is a major cause of death in patients with end-stage renal disease. We investigated the impact of different dialysis treatments on right ventricular function. METHODS:We examined 220 subjects grouped as follows: healthy controls (n = 100), peritoneal dialysis (PD; n = 26), hemodialysis (HD) with radial arteriovenous fistula (AVF; n = 62), and HD with brachial AVF (n = 32). Echocardiography including tissue Doppler imaging (TDI) of the right ventricle was performed in all patients. RESULTS:Pulmonary pressure values progressively rose from controls across the 3 dialysis groups (21.7 ± 6.8, 29.7 ± 6.7, 37.9 ± 6.7 and 40.8 ± 6.6 mm Hg, respectively; p < 0.001). TDI indices of right ventricular function were more impaired in HD patients, particularly in those with brachial AVF. RVD, assessed by TDI myocardial performance index, was higher in HD patients compared with PD patients (71.3 vs. 34.6%, p < 0.001). Moreover, the prevalence of RVD further increased in patients with brachial AVF compared with the radial access (90.6 vs. 61.3%, p < 0.001). CONCLUSIONS:Compared to DP, HD increases the risk of RVD, particularly in the presence of brachial AVF. TDI may detect early functional failure of the right ventricle in HD patients.

journal_name

Am J Nephrol

authors

Paneni F,Gregori M,Ciavarella GM,Sciarretta S,De Biase L,Marino L,Tocci G,Principe F,Domenici A,Luciani R,Punzo G,Menè P,Volpe M

doi

10.1159/000320755

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

432-8

issue

5

eissn

0250-8095

issn

1421-9670

pii

000320755

journal_volume

32

pub_type

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