Abstract 145: Endothelial Dysfunction: A Key Determinant of Ventricular Dysfunction in End-Stage Renal Disease

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Ruth Dubin ◽  
Isabella Guajardo ◽  
Claire Mills ◽  
Catherine Donovan ◽  
Lauren Beussink-Nelson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Dysfunction ◽  
Renal Disease ◽  
Endothelial Function ◽  
End Stage Renal Disease ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
High Rate ◽  
Stage Renal Disease ◽  
End Stage

Objectives: Mechanisms underlying the high rate of cardiovascular mortality in patients with end-stage renal disease (ESRD) are poorly understood. We sought to determine whether endothelial dysfunction is associated with left ventricular (LV) and right ventricular (RV) dysfunction in ESRD. Methods: Stable patients with ESRD (n=75) underwent measurement of: (1) flow-mediated dilation (FMD), using upper arm brachial occlusion, and (2) cardiac mechanics, using speckle-tracking echocardiography (STE). Microvascular function was measured as the velocity time integral (VTI) of hyperemic blood flow following cuff deflation. Eight participants returned for repeat endothelial testing at 1-week intervals. Results: The mean±SD age was 54±11 years, 38% were diabetic, and 17% were on peritoneal dialysis. FMD median (IQR) was 4.7% (2.7-6.9%) and VTI was 0.62m (0.45-0.72m). After adjustment for age, gender, diabetes and systolic blood pressure, lower VTI was associated with worse RV longitudinal free wall strain (β=6.3% per 1m VTI; 95% CI [1.8, 11]; p=0.007). In patients with ejection fraction ≥50%, lower FMD was associated with worse LV global longitudinal strain (β=0.36% per 1% FMD; 95% CI [0.11,0.61]; p=0.005). Mean absolute differences at one week for FMD and VTI were 1.8% and 0.19m. Conclusions: In a diverse cohort of patients on hemo- or peritoneal dialysis, worse endothelial function was associated with LV and RV mechanics after adjustment for clinical factors. Repeatability of FMD and VTI were in accordance with current guidelines. Future studies are needed to investigate whether therapies that improve endothelial function could improve cardiac function in ESRD.

Left ventricular hypertrophy in end-stage renal disease on peritoneal dialysis

1987 ◽  
Vol 60 (4) ◽  
pp. 418-419 ◽  
Author(s):  
Mark Eisenberg ◽  
Sarah Prichard ◽  
Paul Barre ◽  
Robert Patton ◽  
Tom Hutchinson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Left Ventricular Hypertrophy ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Impaired Left Ventricular Global Longitudinal Strain among Patients with Chronic Kidney Disease and End-Stage Renal Disease and Renal Transplant Recipients

2018 ◽  
Vol 9 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Maura Ravera ◽  
Gian Marco Rosa ◽  
Paolo Fontanive ◽  
Elisabetta Bussalino ◽  
Ulrico Dorighi ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Transplant Recipients ◽  
Lv Mass ◽  
Lv Systolic Function ◽  
Stage Renal Disease ◽  
End Stage

Background: Although heart failure is the most prevalent cardiovascular disease associated with adverse outcome in chronic kidney disease (CKD) and after kidney transplantation, left ventricular (LV) systolic function is often preserved in renal patients. The aim of this study was to evaluate global longitudinal strain (GLS), which is reportedly a more accurate tool for detecting subclinical LV systolic dysfunction, in patients with various degrees of renal function impairment, including kidney transplant recipients (KTRs). Methods: This prospective study evaluated demographic, clinical, and ultrasound data, including the assessment of LV GLS and mitral E peak velocity and averaged ratio of mitral to myocardial early velocities (E/e’), of 70 consecutive renal patients (20 with stage 2–4 CKD, 25 with end-stage renal disease on hemodialysis [HD], and 25 KTRs). All patients had an LV ejection fraction ≥50% and no history of heart failure or coronary artery disease. We used multivariable logistic analysis to assess the risk of compromised GLS. One hundred and twenty control subjects with or without hypertension served as controls. Results: A compromised GLS <–18% was shown in 55% of patients with stage 2–4 CKD, 60% of HD patients, and 28% of KTRs, while it was 32% in hypertensive controls and 12% in non-hypertensive controls (p < 0.0001). Patients with HD had higher systolic pressure and a significantly greater prevalence of increased LV mass and diastolic dysfunction. In renal patients, E/e’ (p = 0.025), and LV mass index (p = 0.063) were independent predictors of compromised GLS at logistic regression analysis. E/e’, systolic artery pressure, and LV mass also exhibited the greatest areas under the curve on receiver operating characteristic analysis to identify a compromised GLS. Conclusions: Renal disease proved to be associated with early and subclinical impairment of LV systolic function, which persists after starting dialysis and even in spite of successful kidney transplantation. An increased E/e’ resulted to be the most powerful independent predictor of abnormal GLS.

Outcomes of infants <28 days old treated with peritoneal dialysis for end-stage renal disease

2009 ◽  
Vol 24 (10) ◽  
pp. 2035-2039 ◽  
Author(s):  
Michelle N. Rheault ◽  
Jurat Rajpal ◽  
Blanche Chavers ◽  
Thomas E. Nevins
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals SP284BETA-TRACE PROTEIN CORRELATES WITH ENDOTHELIAL FUNCTION IN PERIPHERAL RESISTANCE ARTERIES IN END STAGE RENAL DISEASE

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii202-iii202
Author(s):  
Samsul Arefin ◽  
Amaryllis Van Craenenbroeck ◽  
Neja Mudrovcic ◽  
Ann-Christin Bragfors-Helin ◽  
Peter Stenvinkel ◽  
...  
Keyword(s):  
Renal Disease ◽  
Endothelial Function ◽  
End Stage Renal Disease ◽  
Peripheral Resistance ◽  
Resistance Arteries ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Coronary microvascular dysfunction is associated with degree of anaemia in end‐stage renal disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ashwin Radhakrishnan ◽  
Luke C. Pickup ◽  
Anna M. Price ◽  
Jonathan P. Law ◽  
Kirsty C. McGee ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Microvascular Dysfunction ◽  
Left Ventricular ◽  
Coronary Microvascular Dysfunction ◽  
Transplant Candidates ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Coronary microvascular dysfunction (CMD) is common in end-stage renal disease (ESRD) and is an adverse prognostic marker. Coronary flow velocity reserve (CFVR) is a measure of coronary microvascular function and can be assessed using Doppler echocardiography. Reduced CFVR in ESRD has been attributed to factors such as diabetes, hypertension and left ventricular hypertrophy. The contributory role of other mediators important in the development of cardiovascular disease in ESRD has not been studied. The aim of this study was to examine the prevalence of CMD in a cohort of kidney transplant candidates and to look for associations of CMD with markers of anaemia, bone mineral metabolism and chronic inflammation. Methods Twenty-two kidney transplant candidates with ESRD were studied with myocardial contrast echocardiography, Doppler CFVR assessment and serum multiplex immunoassay analysis. Individuals with diabetes, uncontrolled hypertension or ischaemic heart disease were excluded. Results 7/22 subjects had CMD (defined as CFVR < 2). Demographic, laboratory and echocardiographic parameters and serum biomarkers were similar between subjects with and without CMD. Subjects with CMD had significantly lower haemoglobin than subjects without CMD (102 g/L ± 12 vs. 117 g/L ± 11, p = 0.008). There was a positive correlation between haemoglobin and CFVR (r = 0.7, p = 0.001). Similar results were seen for haematocrit. In regression analyses, haemoglobin was an independent predictor of CFVR (β = 0.041 95% confidence interval 0.012–0.071, p = 0.009) and of CFVR < 2 (odds ratio 0.85 95% confidence interval 0.74–0.98, p = 0.022). Conclusions Among kidney transplant candidates with ESRD, there is a high prevalence of CMD, despite the absence of traditional risk factors. Anaemia may be a potential driver of microvascular dysfunction in this population and requires further investigation.

scholarly journals A Treatable Encephalopathy in a Peritoneal Dialysis Patient - Cefepime- Induced Encephalopathy

2019 ◽  
Vol 10 (02) ◽  
pp. 324-326 ◽  
Author(s):  
Ching Soong Khoo ◽  
Tze Yuan Tee ◽  
Hui Jan Tan ◽  
Raymond Azman Ali
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Hospital Stay ◽  
End Stage Renal Disease ◽  
Dialysis Patient ◽  
Length Of Hospital Stay ◽  
Peritoneal Dialysis Patient ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

ABSTRACTWe report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients’ outcome.

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