Supplementary Ultrafiltration May Improve Inflammation and Cardiac Dysfunction in Patients with High Interdialytic Weight Gain

Abstract

Background/Aims: We tested the hypothesis that adding an ultrafiltration session per week may improve brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels and left ventricular function in hypervolemic hemodialysis patients. Methods: Twenty-six patients (18 male, 8 female; mean age 57.2 ± 12.7 years) who had high BNP and CRP levels and interdialytic weight gain (IDWG) were recruited for the study. Patients were randomly allocated to one of two groups, namely the supplementary ultrafiltration (sUF) group (n = 13), who had additional ultrafiltrations for 8 weeks, and the regular hemodialysis (rHD) group (n = 13), who continued regular dialysis treatments. Results: There were significant decreases in mean CRP and BNP levels and mean arterial blood pressure and significant improvements in left ventricular function in the sUF group, with no changes in the rHD group. Higher IDWG was observed in the rHD group compared to the sUF group after 8 weeks. Conclusion: sUF may be effective in reducing inflammatory burden and improving cardiac function.

Interdialytic weight gain of less than 2.5% seems to limit cardiac damage during hemodialysis

“…The risk with high IDWG have been emphasized before. 14,[48][49][50] In the present study it was possible to show a breakpoint of IDWG at approximately ⩽ 2.5% for cardiac strain during HD, marked by Pro-BNP. However, TnT rises also in those with lower levels during HD.…”