Russian Heart Failure Journal 2005year Effect of ultrafiltraion during hemodialysis on the left ventricular diastolic filling in patients with chronic renal insufficiency
Effect of ultrafiltraion during hemodialysis on the left ventricular diastolic filling in patients with chronic renal insufficiency
Shutov A.M., Edigarova O.M., Mastykov V.E., Kazankov Yu.N., Poletaev I.V.
Urgency. In patients on hemodialysis (HD), evaluation of left ventricular (LV) diastolic function by transmitral blood flow is difficult because of pronounced fluctuations of water balance due to ultrafiltration during HD and the interdialysis gain of weight induced by retention of fluid. Aim. To elucidate the effect of ultrafiltration during HD on the LV diastolic filling in patients with chronic renal insufficiency (CRI). Materials and methods. Thirty patients (17 women and 13 men; mean age 49±11 years) receiving the treatment with chronic HD were evaluated. HD sessions were performed 3 times a week, for 4 hours each, using a bicarbonate dialyzing solution and polysulphonic dialyzers. Echocardiography (echoCG) and Doppler-echoCG were performed before and after HD. Results. Ultrafiltration comprised 1.1±0.7 l/m2 or 3.0±2.1% of body weight after HD. After HD marked decreases in maximum rate in peak E and E/A ratio were observed. At the same time HD did not significantly affect the propagation velocity of LV early diastolic filling flow in the mode of color M-modal Doppler (Vp). A direct correlation was found between the ultrafiltration value and the dynamics of velocity in peak E (DE) (r=0.46; p=0.01); such correlation with the dynamics of Vp was not observed (r=-0.01; p=0.9). HD resulted in a significant reduction of potassium and sodium levels and an increase in calcium level in blood serum. However the dynamics of electrolyte concentrations was not correlated with the dynamics of transmitral blood flow parameters or Vp.