Russian Heart Failure Journal 2007year Effect of renal replacement therapy on parameters of chronic heart failure in patients with chronic renal disease
Effect of renal replacement therapy on parameters of chronic
heart failure in patients with chronic renal disease
Belov V.V., Iljicheva O.E.
Urgency. Manifestations of CHF are various and have a high prevalence in patients with chronic renal disease (CRD). Revealing a potential reversibility of CHF manifestations at certain stages of CRD would permit timely and adequate correction of RF for cardiac complications. Aim: Studying clinical manifestations of CHF along with structure-activity alterations of the myocardium in patients with end-stage CRD at the pre-dialysis step and on the first year of maintenance hemodialysis. Materials and methods. Data of clinical and echoCG examinations were analyzed for 65 patients with IV–V stage CRD (29 men and 36 women, mean age 43.1±11.1 years) at the pre-dialysis step and on the first year according to National Guidelines on CHF Diagnostics and Treatment (2003). Results. By clinical and functional data, CHF in pre-dialysis CRD was diagnosed in 56 (86.2%) patients: 19 (33.9%) patients had I stage CHF, 28 (50%) patients had IIА CHF, and 9 (16.1%) patients had IIB CHF. On the first year of maintenance hemodialysis, the diagnosis of CHF was canceled in 14 (25%) patients and confirmed in 42 (75%) patients: 22 (52.4%) patients had I stage CHF; 17 (40.5%) patients had IIА stage CHF; 3 (7.1%) patients had IIB stage CHF. All cases of CHF were evident as myocardial diastolic dysfunction and in some cases it was combined with systolic dysfunction (16.1% and 7.1% at the pre-dialysis step and on the first year of hemodialysis, respectively). On the first year of renal replacement therapy, incidence of CHF decreased by 21.6% to make up 64.6% cases. The first stage began to predominate in the CHF structure; proportions of IIA and IIB reduced 1.2 and 2.3 times, respectively.