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Effect of anemia on cardiac disorders in pre-dialysis patients immediately before starting hemodialysis

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Abstract

Introduction

Anemia is a common complication of patients with chronic kidney disease (CKD), which not only lowers their quality of life but also potentially causes cardiovascular diseases such as congestive heart failure and coronary heart disease, and accelerates the progression of renal dysfunction.

Methods

Pre-dialysis patients were assigned to groups A, B, C or D based on hemoglobin levels of ≤8.9 (n = 48), 9.0–9.9 (n = 63), 10–10.9 (n = 53), and ≥11.0 g/dL (n = 39), respectively. Cardiac function was estimated using echocardiography to clarify the relationship between anemia and cardiac disorders in patients with CKD immediately before starting hemodialysis.

Results

Left ventricular ejection fraction (LVEF) was significantly higher in group D than in groups A and B. The fractions with an LVEF of less than 50% were 16.7, 4.8, 1.9, and 0% in groups A, B, C, and D, respectively. Posterior wall thickness was statistically thicker and the deceleration time of the early diastolic wave was longer in groups A and B, respectively, than in groups C and D. The left ventricular mass index in group D was significantly lower than in any other groups.

Conclusion

Anemia in pre-dialysis patients with CKD is a probable cause of impaired left ventricular systolic function and progressive left ventricular hypertrophy. Our results suggest that Hb levels should be maintained at >11 g/dL by EPO administration from the perspective of protecting cardiac function, although the upper limit of the target Hb level was undetermined.

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Acknowledgments

This work was supported by a grant-in-aid for scientific research.

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Authors and Affiliations

  1. Division of Nephrology, Shuwa General Hospital, 1200 Yahara-Shinden, Kasukabe, Saitama, 344-0035, Japan

    Michio Kuwahara, Soichiro Iimori, Tamaki Kuyama, Wataru Akita, Yoshihiro Mori, Tomoki Asai & Yusuke Tsukamoto

  2. Division of Cardiology, Shuwa General Hospital, Kasukabe, Japan

    Susumu Adachi

  3. Department of Nephrology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan

    Tatemitsu Rai, Shinichi Uchida & Sei Sasaki

Authors
  1. Michio Kuwahara
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  2. Soichiro Iimori
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  3. Tamaki Kuyama
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  4. Wataru Akita
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  5. Yoshihiro Mori
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  6. Tomoki Asai
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  7. Yusuke Tsukamoto
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  8. Susumu Adachi
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  9. Tatemitsu Rai
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  10. Shinichi Uchida
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  11. Sei Sasaki
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Corresponding author

Correspondence to Michio Kuwahara.

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Kuwahara, M., Iimori, S., Kuyama, T. et al. Effect of anemia on cardiac disorders in pre-dialysis patients immediately before starting hemodialysis. Clin Exp Nephrol 15, 121–125 (2011). https://doi.org/10.1007/s10157-010-0360-6

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  • DOI: https://doi.org/10.1007/s10157-010-0360-6

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