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Impact of volume control on left ventricular hypertrophy in dialysis patients.

Abstract

BACKGROUND

Left ventricular hypertrophy (LVH), which strongly predicts cardiac mortality, is seen in more than 60% of end-stage renal disease patients. The aim of this study was to prospectively investigate the effect of salt restriction and strict volume control on blood pressure and LVH.

METHOD

Nineteen hypertensive patients on chronic hemodialysis (HD) treatment (age 52 +/- 17 years, 7 women) were included in the study. Treatment consisted of 12-h HD per week, during which as much ultrafiltration (UF) was applied as possible without an excessive blood pressure (BP) drop. Special attention was given to dietary salt restriction. Predialysis mean BP (MBP), body weight (BW), cardio-thoracic index (CTI) and echocardiographic results were recorded at baseline and after 6 and 12 months.

RESULTS

All patients reached acceptable BP (< 140/90 mmHg) within three months (10-75 days) with our strict volume control strategy. Mean pre-dialysis BP was 127 +/- 17/78 +/- 9 mm Hg at baseline, 120 +/- 9/75 +/- 6 mm Hg at the 6th month and 118 +/- 11/73 +/- 5 mm Hgat the 12th month. The incidence of symptomatic hypotension gradually decreased from a mean of 22% to 11% and 7%, respectively during follow-up. Left ventricular mass index decreased from 164 +/- 64 to 112 +/- 36 g/m2. CTI, left atrial, left ventricular systolic and diastolic diameters significantly decreased in all patients. Inter-dialytic weight gain was 930 +/- 70 g/day in the follow-up period. Hematocrit did not significantly differ at the first, second and last visits.

CONCLUSION

Normal BP and improvement of cardiac structure, in particular a reduction of LVH could be reached in all our patients by intensifying salt restriction and UF.

Authors+Show Affiliations

,

Department of Nephrology, Ege University Medical Faculty, Bornova, Izmir, Turkey. m.ozkahya@ixir.com

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Source

Journal of nephrology 15:6 pg 655-60

MeSH

Adult
Aged
Analysis of Variance
Blood Pressure Determination
Body Weight
Chi-Square Distribution
Cohort Studies
Diet, Sodium-Restricted
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Function Tests
Humans
Hypertension
Hypertrophy, Left Ventricular
Male
Middle Aged
Prospective Studies
Renal Dialysis
Renal Insufficiency
Risk Assessment
Treatment Outcome

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12495279

Citation

Ozkahya, Mehmet, et al. "Impact of Volume Control On Left Ventricular Hypertrophy in Dialysis Patients." Journal of Nephrology, vol. 15, no. 6, 2002, pp. 655-60.
Ozkahya M, Toz H, Qzerkan F, et al. Impact of volume control on left ventricular hypertrophy in dialysis patients. J Nephrol. 2002;15(6):655-60.
Ozkahya, M., Toz, H., Qzerkan, F., Duman, S., Ok, E., Basci, A., & Mees, E. J. (2002). Impact of volume control on left ventricular hypertrophy in dialysis patients. Journal of Nephrology, 15(6), pp. 655-60.
Ozkahya M, et al. Impact of Volume Control On Left Ventricular Hypertrophy in Dialysis Patients. J Nephrol. 2002;15(6):655-60. PubMed PMID: 12495279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of volume control on left ventricular hypertrophy in dialysis patients. AU - Ozkahya,Mehmet, AU - Toz,Huseyin, AU - Qzerkan,Filiz, AU - Duman,Soner, AU - Ok,Ercan, AU - Basci,Ali, AU - Mees,Evert J Dorhout, PY - 2002/12/24/pubmed PY - 2003/3/28/medline PY - 2002/12/24/entrez SP - 655 EP - 60 JF - Journal of nephrology JO - J. Nephrol. VL - 15 IS - 6 N2 - BACKGROUND: Left ventricular hypertrophy (LVH), which strongly predicts cardiac mortality, is seen in more than 60% of end-stage renal disease patients. The aim of this study was to prospectively investigate the effect of salt restriction and strict volume control on blood pressure and LVH. METHOD: Nineteen hypertensive patients on chronic hemodialysis (HD) treatment (age 52 +/- 17 years, 7 women) were included in the study. Treatment consisted of 12-h HD per week, during which as much ultrafiltration (UF) was applied as possible without an excessive blood pressure (BP) drop. Special attention was given to dietary salt restriction. Predialysis mean BP (MBP), body weight (BW), cardio-thoracic index (CTI) and echocardiographic results were recorded at baseline and after 6 and 12 months. RESULTS: All patients reached acceptable BP (< 140/90 mmHg) within three months (10-75 days) with our strict volume control strategy. Mean pre-dialysis BP was 127 +/- 17/78 +/- 9 mm Hg at baseline, 120 +/- 9/75 +/- 6 mm Hg at the 6th month and 118 +/- 11/73 +/- 5 mm Hgat the 12th month. The incidence of symptomatic hypotension gradually decreased from a mean of 22% to 11% and 7%, respectively during follow-up. Left ventricular mass index decreased from 164 +/- 64 to 112 +/- 36 g/m2. CTI, left atrial, left ventricular systolic and diastolic diameters significantly decreased in all patients. Inter-dialytic weight gain was 930 +/- 70 g/day in the follow-up period. Hematocrit did not significantly differ at the first, second and last visits. CONCLUSION: Normal BP and improvement of cardiac structure, in particular a reduction of LVH could be reached in all our patients by intensifying salt restriction and UF. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/12495279/full_citation L2 - https://medlineplus.gov/highbloodpressure.html DB - PRIME DP - Unbound Medicine ER -