Experimental Uremic Cardiomyopathy � Fact or Fiction?

Lübbecke, Friedrich; Steudle, V.; Schaper, J.; Wizemann, V.

doi:10.1159/000413131

Cited by 3 publications

(1 citation statement)

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“…This is most likely due to uncoupling of the receptor or an inhibition of the receptor by the uremic toxins [19]. In chronic uremic rats, the density of · 1 and · 2 receptors in the cerebral cortex was significantly increased, while the ß-adrenergic and muscarinergic receptors in the heart as well as cardiac · 1 adrenoceptors were unchanged [18][19][20]. Studies in uremic rats also show variable decreases in contraction of isolated myocytes along with a decrease in the velocity of shortening and relaxation [21][22][23].…”

Section: Ckd As the Substrate For Cardiac Arrhythmiasmentioning

confidence: 99%

Chronic Kidney Disease and Sudden Death: Strategies for Prevention

McCullough

Sandberg²

2004

Blood Purif

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The association between chronic kidney disease and cardiovascular death is accounted for, in part, by higher rates of serious arrhythmias. Research shows an independent relationship between worsened renal function and atrial fibrillation, heart block, ventricular tachycardia, ventricular fibrillation, and asystole. These higher rates also associate with underlying structural heart disease including left ventricular hypertrophy, cardiac fibrosis, valvular disease, and left ventricular systolic and diastolic dysfunction. In addition, chronic intermittent ischemia is implicated in the arrhythmias observed during hemodialysis. The superimposed conditions of acidosis and fluxes in both potassium and magnesium also contribute to higher rates of arrhythmias. Baseline estimated glomerular filtration rate is linked to worsened outcomes and increased defibrillation thresholds in patients receiving implantable cardioverter defibrillators. Preventive strategies include meticulous management of electrolytes, baseline treatment for cardiovascular disease, and when indicated, implantable cardioverter defibrillators. Future research into the mechanisms and prevention of sudden cardiac death in patients with chronic kidney disease is warranted.

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Section: Ckd As the Substrate For Cardiac Arrhythmiasmentioning

confidence: 99%

Chronic Kidney Disease and Sudden Death: Strategies for Prevention

McCullough

Sandberg²

2004

Blood Purif

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Factors Which Affect Cardiac Performance during Hemodialysis

Travis

Henrich

1989

Seminars in Dialysis

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Summary Cardiac performance during hemodialysis is dependent on preexisting conditions (i.e., coronary artery disease, myocardial hypertrophy, LV compliance, anemia, hypertension, etc.) and the hemodynamic alterations caused by the dialysis procedure itself (osmotic shifts, ionized calcium changes, etc.). Clinical hemodynamic investigations of cardiac performance during uremia have been hampered by the difficulty in isolating individual parameters of ventricular function. Myocardial reserve in dialysis patients is often reduced because of antecedent ischemic disease, hypertension, and the presence of autonomic dysfunction in many patients. Rapid volume losses or gains are likely to be less well tolerated with resultant hypotensive syndromes or pulmonary edema as the result. The controlled volume loss achievable with newer dialysis machines, the use of higher dialysate sodium concentrations, and the wider availability of erythropoietin may improve the tolerance to the procedure for many patients.

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