scholarly journals Clinical and Echocardiographic Factors Associated with Right Ventricular Systolic Dysfunction in Hemodialysis Patients

2016 ◽  
Vol 6 (3) ◽  
pp. 230-236
Author(s):  
Juan Manuel López-Quijano ◽  
Antonio Gordillo-Moscoso ◽  
Jesús Antonio Viana-Rojas ◽  
Jorge Carrillo-Calvillo ◽  
Peter B. Mandeville ◽  
...  
Keyword(s):  
Right Ventricular ◽  
End Stage Renal Disease ◽  
Systolic Dysfunction ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction ◽  
Factors Associated ◽  
Relaxation Velocity ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic kidney disease is a disorder of epidemic proportions that impairs cardiac function. Cardiovascular diseases are the leading cause of death in hemodialysis patients, and the understanding of new nontraditional predictors of mortality could improve their outcomes. Right ventricular systolic dysfunction (RVSD) has recently been recognized as a predictor of cardiovascular death in heart failure and hemodialysis patients. However, the factors contributing to RVSD in hemodialysis patients remain unknown. The aim of this study was to evaluate the clinical and echocardiographic factors associated with RVSD in hemodialysis patients. Methods: A cross-sectional study was conducted in which 100 outpatients with end-stage renal disease on chronic hemodialysis were evaluated. A transthoracic echocardiographic examination was performed at optimal dry weight. Right ventricular systolic function was evaluated using tricuspid annular plane systolic excursion (TAPSE). Clinical and echocardiographic data were recorded for each patient. A multivariate linear logistic regression was created using RVSD (TAPSE <14 mm) as the dependent variable. Results: Fifteen patients with RVSD and 85 patients without RVSD were analyzed. TAPSE had a positive correlation with left ventricular ejection fraction (LVEF) and myocardial relaxation velocity. Independent contributors to RVSD were LVEF (OR 1.14, 95% CI 1.05-1.26), left ventricular mass index (OR 1.02, 95% CI 1.00-1.04), and myocardial relaxation velocity (OR 1.81, 95% CI 1.18-3.19). Conclusions: Echocardiographic factors were significant contributors to RVSD. These measurements could be included as part of the routine workup in all end-stage renal disease patients on hemodialysis.

scholarly journals Echocardiographic assessment of cardiac dysfunction in maintenance hemodialysis patients

2017 ◽  
Vol 5 (2) ◽  
pp. 97-100
Author(s):  
Md Zahid Alam ◽  
Mohammad Zakir Hossain
Keyword(s):  
Wall Motion ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Maintenance Hemodialysis ◽  
Ventricular Systolic Dysfunction ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage

Background and Objectives: The hemodialysis (HD) procedure may acutely induce regional left ventricular systolic dysfunction. This study evaluated the echocardiographic parameters in patients with End Stage Renal Disease (ESRD) on HD and to correlate those with clinical findings, more specifically to see whether there is any change in ejection fraction (EF) by developing new regional wall motion abnormality (RWMA) after hemodialysis, and to correlate these changes with the symptoms & hemodynamic condition of the patients.Methodology: This prospective observational study was carried on a total of 100 adult ambulant patients with end stage renal disease (ESRD) on maintenance hemodialysis in the department of Hemodialysis, BIRDEM General Hospital, Shahbag, Dhaka. Their echocardiogram was done 30 min before and after the hemodialysis.Result: It was revealed that majority of the patients were above 60 years (39%), and male to female ratio of about 3:2. The study subjects had diabetes mellitus (79%), hypertension (96%), dyslipidemia (42%), and family history of ischemic heart disease (24%). Chest pain and breathlessness were present in 31% and 42% subjects respectively before hemodialysis. Palpitation (23%), dizziness (19%), oedema (43%) and raised JVP (15%) were seen in the study subjects. Mean (±SD) serum creatinine level was 9.38 (±2.22) mg/dl and hemoglobin level was 9.0 (±1.08) g/dl. Ejection fraction (EF) before hemodialysis were ?55, 40-54 & 30-39 in 62%, 34% and 4% study subjects respectively and after hemodialysis it was ?55, 40-54 & 30-39 in 44%, 46% and 10% study subjects respectively. After HD, left ventricular failure (LVF) occurred in 32% subjects. HD-induced regional left ventricular systolic dysfunction occurred in total 36 patients (36%) and total 14 (14%) patients developed LVF 30 minutes after dialysis. Patients with hemodialysis-induced left ventricular systolic dysfunction were more in those who had worse predialysis EF. Blood pressure, heart rate, chest pain, palpitation, raised Jugular Venous Pressure (JVP) and edema did not differ significantly before and after hemodialysis. Simple regression analysis revealed that the hemodialysis procedure significantly (P<0.05) induce regional left ventricular systolic dysfunction.Conclusions: HD acutely induces regional wall motion abnormalities in a significant proportion of patients. It occurs within 30 min after hemodialysis and is not related to changes in blood pressure, heart rate, JVP and oedema.Bangladesh Crit Care J September 2017; 5(2): 97-100

scholarly journals FACTORS AFFECTING NON-ADHERENCE TO TREATMENT OF HEMODIALYSIS PATIENTS IN MAKKAH CITY, KINGDOM OF SAUDI ARABIA

2020 ◽  
Vol 3 (14) ◽  
pp. 21-38
Author(s):  
Ghanim. Hamid. Al-Khattabi
Keyword(s):  
Saudi Arabia ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Adherence To Treatment ◽  
Adherence Behavior ◽  
Factors Associated ◽  
Dialysis Duration ◽  
Stage Renal Disease ◽  
End Stage

Background: Adherence of hemodialysis patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. There is solid evidence that non-adherence of end-stage renal disease patients correlates with morbidity and mortality, is the norm for dialysis patients rather than the exception, multiple factors influence it and inconsistencies exist in findings of the relationships between risk factors and non-adherence. Despite the importance of this topic, there is remarkable paucity in the studies which identify factors associated with non-adherence in hemodialysis patients in Saudi Arabia. Objectives: To determine factors related to non-adherence to fluid, diet, medication, and hemodialysis sessions among hemodialysis patients in Makkah. Materials and Methods: The current study is a cross-sectional one, where a sample of 361 hemodialysis patients was selected randomly from hemodialysis centers in three governmental hospitals in Makkah in order to determine factors related to their non-adherence to treatment by using an end-stage renal disease-adherence questionnaire (ESRD-AQ) in addition to clinical examination and laboratory investigation for other data. Results: Younger (<30 years), unmarried, non-Saudis, those with chronic diseases other than hypertension and diabetes mellitus, and those with long dialysis duration (60+ months) were found more likely to be non-adherent to the fluid. Females patients and those with short dialysis duration (<60 months) were found more likely to be non-adherent to diet and medications, respectively. Conclusion: Patients who had factors associated with non-adherence deserve special attention and support to improve their adherence behavior. The findings from this study can be used as a base for designing an intervention aimed to increase the adherence to treatment in end-stage renal disease patients who are undergoing hemodialysis in order to decrease the direct and indirect cost that appear as a consequence of non-adherence.

scholarly journals DETERMINANTS OF ADHERENCE TO TREATMENT AMONG HEMODIALYSIS PATIENTS IN MAKKAH CITY, KINGDOM OF SAUDI ARABIA

2021 ◽  
Vol 4 (17) ◽  
pp. 95-112
Author(s):  
Ghanim. Hamid. Al-Khattabi
Keyword(s):  
Saudi Arabia ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Adherence To Treatment ◽  
Factors Associated ◽  
Dialysis Duration ◽  
Stage Renal Disease ◽  
End Stage ◽  
Makkah City

Background: Adherence of hemodialysis patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. There is solid evidence that non-adherence to end-stage renal disease patients correlates with morbidity and mortality, is the norm for dialysis patients rather than the exception, multiple factors influence it and inconsistencies exist in findings of the relationships between risk factors and non-adherence. Despite the importance of this topic, there is remarkable paucity in the studies which identify factors associated with non-adherence in hemodialysis patients in Saudi Arabia. Aims and Objectives: The current study aims at ameliorating the adverse consequences of non-adherence among hemodialysis patients through providing scientific background and a better understanding of the factors associated with non-adherence. The objectives of this study were to determine factors related to non-adherence to fluid, diet, medication, and hemodialysis sessions among hemodialysis patients in Makkah city. Materials and Methods: The present study is a cross-sectional one, where a sample of 361 hemodialysis patients was selected randomly from hemodialysis centers in three governmental hospitals in Makkah in order to determine factors related to their non-adherence to treatment by using an end-stage renal disease-adherence questionnaire (ESRD-AQ) in addition to clinical examination and laboratory investigation for other data. Results: Younger (<30 years), unmarried, non-Saudis, those with chronic diseases other than hypertension and diabetes mellitus, and those with long dialysis duration (60+ months) were found more likely to be non-adherent to fluid. Females patients and those with short dialysis duration (<60 months) were found more likely to be non-adherent to diet and medications, respectively. Conclusion: Patients who had factors associated with non-adherence deserve special attention and support to improve their adherence behavior. The findings from this study can be used as a base for designing an intervention aimed to increase the adherence to treatment in end-stage renal disease patients who are undergoing hemodialysis in order to decrease the direct and indirect costs that appear as a consequence of non-adherence.

Sign in / Sign up

Export Citation Format

Share Document