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.

• Authors: Tyler Friesen, Davinder S Jassal, Mike Zhu, Frederick Eng, Claudio Rigatto, Navdeep Tangri, Manish M Sood, Erin Karlstedt, Sheena Premecz, Paul Komenda
• Journal: Clinical and experimental nephrology (Clin Exp Nephrol) Vol. 19 Issue 3 Pg. 514-20 (Jun 2015) ISSN: 1437-7799 [Electronic] Japan
• PMID: 24894700 (Publication Type: Journal Article)

Topics

• Adult
• Atrial Remodeling
• Echocardiography
• Female
• Hemodialysis, Home
• Humans
• Hypertrophy, Left Ventricular (diagnostic imaging, physiopathology)
• Kidney Failure, Chronic (complications, therapy)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Self Care
• Stroke Volume
• Time Factors
• Ventricular Dysfunction, Left (physiopathology)
• Ventricular Remodeling