engleski

Predictors of Cardiovascular Risk in Chronic Haemodialysis Patients as Assessed with Radionuclide Ventriculography

The aim of this study was to investigate left ventricular performance and exercise capacity in chronic hemodialysis patients, and to identify independent predictors of hemodialysis treatment outcome. Methods: Forty patients, mean age 38 ± 11 years, having regular hemodialysis were examined by means of maximum exercise testing and radionuclide equilibrium ventriculography, and were followed up. The outcome measures were death and cardiovascular complications at the end of follow-up. The independent variables were identified with the multiple linear regressions. Results: The patients were folowed up for 9.3 ± 2.6 years. Patients achieved increase in heart rate during exercise from 73 ± 11 to 113 ± 15 beats/min, workload of 76.4 ± 18.0 Wats, exercise duration 8.7 ± 2.1 min, and mean blood pressure was 250 ± 32 mm Hg. Ejection fraction (EF) raised from 59 ± 10 at rest to 63 ± 11 % during stress ; end-diastolic volume changed from 111 ± 33 to 102 ± 27 ml/m² ; end-systolic volume from 45 ± 19 to 34 ± 16 ml/m² ; and cardiac output from 4.7 ± 1.7 to 7.5 ± 2.2 l/m². Multivariable regression analysis showed direct relationship between increasing EDVI at rest and increasing death risk, as well as cardiovascular complications. Conclusion: Patients on chronic hemodialysis have significant enlargement of left ventricular volumes and elevated cardiac output. But, multiple regression analysis identified only left ventricular end-diastolic volume as one of the significant determinants for survival, but enlargement was not independent.

prognosis; ventricular function; haemodialysis

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