Effects of Residual Renal Function on Left Ventricle and Analysis of Related Factors in Patients with Hemodialysis

Abstract

Background: Left ventricular hypertrophy (LVH) and systolic dysfunction would predict the mortality of patients undergoing maintenance hemodialysis. The cause of LVH is usually related to the increase of total peripheral vascular resistance and overloading volume. The presence of residual diuresis enables greater control of the volume. This study evaluated the effects of residual renal function (RRF) on the left ventricle and analyzed the related factors involved in hemodialysis patients. Methods: A total of 59 hemodialysis patients were classified into two groups. The patients in the RRF (RRFþ) group had a urine volume greater than 200 mL/24 h, and the patients in the non-RRF (RRFÀ) group had a urine volume less than 200 mL/24 h. B-type natriuretic peptide (BNP), blood total homocysteine (tHcy), and blood biochemical indexes were determined for the patients in both groups. Echocardiography and Doppler tests were performed to determine the cardiac indexes. Results: LVH and systolic dysfunction in the RRFþ group were less severe than those in the RRFÀ group. The concentration of tHcy and BNP in patients with RRF was decreased in comparison with those without RRF. The concentration of tHcy and BNP was positively correlated with the residual diuresis. Conclusions: There were distinct ventricular geometric patterns and different functional performances between RRFþ and RRFÀ groups. The presence of residual diuresis had a beneficial effect on the left ventricular function in hemodialysis patients.

The Effect of Increased Frequency of Hemodialysis on Volume-Related Outcomes: A Secondary Analysis of the Frequent Hemodialysis Network Trials

“…Furthermore, there was a significant interaction between residual daily UVol and treatment effect on IDWG in both trials (for TIFL it was significant in the Daily Trial only). In accordance with already published results [17,18], the presence of high baseline urinary volume may have also reduced the effects of frequent HD on LVM change [24,25] .…”

“…Reduction of ECF is known to be followed by a reduction in blood pressure and consequently LVM [24,25] . In the Daily Trial, an association was found between change in predialysis SBP over the 12-month study period and change in LVM (slope estimate 6.6 g per 10 mm Hg in the group receiving 3/week HD and 10.1 g per 10 mm Hg in the group assigned to frequent HD) [17] .…”

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

“…Studies have showed that RRF had beneficial effects on LV hypertrophy and fluid removal. 22 Loss of RRF led to fluid overload which enhanced the burden of LV and contributed to LV dysfunction. Wen et al showed that higher peritoneal dialysate glucose concentration (PDGC) was significantly associated with low RRF and significantly associated with higher allcause and CVD mortality.…”

Impact of residual urine volume decline on the survival of chronic hemodialysis patients in Kinshasa

“…In this regard, increasing evidence suggests that the preservation of RUV contribute in favorable way on the predictors of mortality in HD such as hypervolemia [11], left ventricular hypertrophy (LVH) and congestive heart failure [12, 13], heart rhythm disorders [14] and ischemic strokes [15]. In fact, Ma and Ding [16] found, in a case-control study, that the frequency of LVH and systolic dysfunction was significantly lower in patients with preserved RRF (RUV ≥ 200 ml/day) compared to those having lost RRF (RUV ˂ 200 ml/day). Furthermore, similar findings with respect to plasma concentration of B-type natriuretic peptide (BNP) and homocysteine were also reported [16].…”

“…In fact, Ma and Ding [16] found, in a case-control study, that the frequency of LVH and systolic dysfunction was significantly lower in patients with preserved RRF (RUV ≥ 200 ml/day) compared to those having lost RRF (RUV ˂ 200 ml/day). Furthermore, similar findings with respect to plasma concentration of B-type natriuretic peptide (BNP) and homocysteine were also reported [16]. …”