Cardiovascular remodeling during long-term nocturnal home hemodialysis.

Abstract:

BACKGROUND:Cardiovascular disease is the leading cause of morbidity and mortality in patients with kidney failure. Nocturnal home hemodialysis (NHD) is a form of kidney replacement therapy whereby hemodialysis is performed for at least 6-h overnight, at least 4 days per week. Little is known about the effects of NHD on cardiovascular remodeling as assessed by transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR). OBJECTIVES:The primary objective of the study was to determine the long-term effects of NHD on cardiovascular remodeling using different imaging modalities over a one-year follow-up. METHODS AND RESULTS:A total of 11 patients were included in the study (6 males, mean age 48 ± 16 years) between 2009 and 2011 inclusive at a single tertiary care center. All patients underwent TTE and CMR at baseline and after 1 year of NHD. Left ventricular mass index decreased significantly at 1 year by both TTE (152 ± 7-129 ± 8 g/m(2), p < 0.05) and CMR (162 ± 4-124 ± 4 g/m(2), p < 0.05). There was also a significant decrease in both left and right atrial volume as well as in right ventricular mass index over 1 year of follow-up. Diastolic dysfunction, graded from 0 to 4, improved from a baseline grade of 3.4 to 1.2 at 1-year follow-up. CONCLUSIONS:Long-term nocturnal hemodialysis leads to favorable cardiovascular remodeling with a reduction in cavity dimensions, regression of left ventricular hypertrophy, and an improvement in diastolic function, as assessed by both TTE and CMR.

journal_name

Clin Exp Nephrol

authors

Friesen T,Jassal DS,Zhu M,Eng F,Rigatto C,Tangri N,Sood MM,Karlstedt E,Premecz S,Komenda P

doi

10.1007/s10157-014-0992-z

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

514-20

issue

3

eissn

1342-1751

issn

1437-7799

pii

10.1007/s10157-014-0992-z

journal_volume

19

pub_type

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