Cardiovascular remodeling during long-term nocturnal home hemodialysis
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).
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/m2, p < 0.05) and CMR (162 ± 4–124 ± 4 g/m2, 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.
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.
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- Cardiovascular remodeling during long-term nocturnal home hemodialysis
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Clinical and Experimental Nephrology
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- Home hemodialysis
- High dose hemodialysis
- Left ventricular hypertrophy
- Cardiac imaging
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- Author Affiliations
- 1. Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- 4. Institute of Cardiovascular Sciences, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada
- 5. Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- 6. Department of Radiology, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada
- 2. Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- 3. Seven Oaks General Hospital Kidney Health Program, Winnipeg, MB, Canada
- 7. University of Manitoba, Seven Oaks Hospital Renal Program, 2300 Mcphillips Street, 2PD12, Winnipeg, MB, R2V 3M3, Canada