Title of article :
The effect of intensive hemodialysis on pulmonary arterial pressure and left ventricular systolic function in patients with end-stage renal disease; a prospective clinical trial
Author/Authors :
Akiash, Nehzat Atherosclerosis Research Center - Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran , Ahmadi Halili, Shahla Chronic Renal Failure Research Center - Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran , Darabi, Forough Atherosclerosis Research Center - Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran , Moradi, Maryam Department of Biostatistics and Epidemiology - School of Public Health - Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Abstract :
Introduction: End-stage renal disease (ESRD) requires hemodialysis or kidney transplantation
for the patients to survive.
Objectives: The present study was conducted to examine whether intensive hemodialysis and
hemoglobin (Hb) concentration correction can improve left ventricular (LV) function and
pulmonary arterial hypertension in ESRD patients?
Patients and Methods: This prospective clinical trial was designed to examine patients
referring to public hospitals in Ahvaz, Iran, in 2016-2017. All the patients treated with
intensive hemodialysis for two months were included in the study. The Hb concentration was
corrected by the subcutaneous injection of erythropoietin at the dose of 50-150 IU/kg three
times per week.
Results: Thirty-one ESRD patients with high pulmonary arterial pressure participated in this
study. After the intervention, blood Hb levels increased significantly in the ESRD patients
from 9.20±1.39 g/dL to 10.96±1.01 g/dL (P<0.0001). Pulmonary arterial pressure decreased
significantly from 53.52±10.63 mmHg to 43.32±10.92 mm Hg (P<0.0001). Left ventricular
ejection fraction increased significantly based on the visual assessment and Simpson’s method
(2D echocardiography) from 41.06±10.76 to 43.00±11.28 and 46.26±13.72 to 48.36±13.90,
respectively (P<0.0001). Absolute value of two dimensional global longitudinal strain (GLS)
increased significantly from 13.99±5.05 to 15.14±5.32 (P<0.0001) after the intervention.
Conclusion: Intensive hemodialysis for two months resulted in a significant increase in Hb
concentrations, improved the LV systolic function and decreased pulmonary hypertension in
ESRD patients.
Keywords :
Chronic kidney disease , Hemodialysis , Pulmonary hypertension , Global longitudinal strain
Journal title :
Journal of Renal Injury Prevention