Hemodialysis‐induced cardiovascular disease

Ahmadmehrabi, Shadi; Tang, W.H. Wilson

doi:10.1111/sdi.12694

Cited by 129 publications

(107 citation statements)

References 120 publications

(213 reference statements)

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“…We found that a longer hemodialysis vintage was associated with a higher healthcare cost. This can be explained by the fact that long-term dialysis patients possibly required more treatments, or experienced more complications [ 48 , 49 , 50 , 51 ], which, in turn, increased the treatment burden [ 52 ]. Comorbidities were associated with a higher healthcare cost in the current study.…”

Section: Discussionmentioning

confidence: 99%

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Doan

Nguyen

et al. 2020

IJERPH

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We examined factors associated with healthcare cost, health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) in hemodialysis patients. We conducted a cross-sectional study on 160 patients from January to April 2019 at a hemodialysis center. Socio-demographic, clinical, and laboratory parameters and quality of life (QOL) (using KDQOL-SF-v1.3) were assessed. Monthly healthcare costs were extracted from the hospital information system. The means of healthcare cost, HRQOL, and KDQOL were VND 9.4 ± 1.6 million, VND 45.1 ± 21.9 and VND 51.3 ± 13.0, respectively. In the multivariate analysis, the healthcare cost was higher in patients with a longer hemodialysis vintage (regression coefficient (B): 0.74; 95% confidence interval (95% CI): 0.25; 1.23), comorbidity (B: 0.77; 95% CI: 0.24; 1.31); and lower in those with a higher hematocrit concentration (B: −0.07; 95% CI: −0.13; −0.01). Patients that lived in urban areas (B: 9.08; 95% CI: 2.30; 15.85) had a better HRQOL; those with a comorbidity (B: −14.20; 95% CI: −21.43; −6.97), and with hypoalbuminemia (B: −9.31; 95% CI: −16.58; −2.04) had a poorer HRQOL. Patients with a higher level of education (B: 5.38~6.29) had a better KDQOL; those with a comorbidity had a poorer KDQOL (B: −6.17; 95% CI: −10.49; −1.85). In conclusion, a longer hemodialysis vintage, a comorbidity and a lower hematocrit concentration were associated with higher healthcare costs. Patients who lived in urban areas had a better HRQOL and a higher level of education led to a better KDQOL. Patients with a comorbidity had a lower HRQOL and KDQOL. Malnourished patients had a lower HRQOL.

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Section: Discussionmentioning

confidence: 99%

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Doan

Nguyen

et al. 2020

IJERPH

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“…In particular, end‐stage CKD patients treated with hemodialysis are considered to be at very high cardiovascular risk that is related both to an increased prevalence of traditional cardiovascular risk factors and the effects of CKD‐related factors (ie, dialysis per se, periodic volume overload, uremia, chronic inflammation and increased oxidative stress, mineral disorders, anemia, etc) . In hemodialysis patients, atherosclerotic changes, calcifications, and impaired coronary endothelial function may lead to coronary microvascular and epicardial vascular dysfunction and consequently to chronic myocardial ischemia . Increased aortic stiffness is also very common in these patients and may also contribute to impaired left ventricular function and myocardial ischemia …”

Section: Introductionmentioning

confidence: 99%

Impaired coronary microcirculation is associated with left ventricular diastolic dysfunction in end‐stage chronic kidney disease patients

et al. 2020

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Introduction: Coronary vascular dysfunction, as assessed by coronary flow reserve (CFR) in the left anterior descending coronary artery, is found in various conditions including end-stage chronic kidney disease (CKD). Currently, we investigated the associations of CFR with echocardiographic indices of systolic and diastolic cardiac function and identified independent predictors of CFR in hemodialysis patients. Methods: End-stage CKD patients treated with hemodialysis (n = 29) without known cardiovascular disease were recruited from a Hemodialysis Unit in Northwestern Greece. A thorough echocardiographic evaluation including CFR measurement following dipyridamole infusion was performed in all participants. Arterial stiffness was assessed by measurement of carotid-femoral pulse wave velocity and aortic augmentation index. Results: The mean age of the patients was 63 years, and mean duration of hemodialysis was 2.9 years. CFR was 1.60 ± 0.37 while dipyridamole caused a significant increase in E' sep , S lat , E' lat , and Stroke volume (P < .05 for all). Independent predictors of CFR were posterior wall thickness (B −0.408, P = .013) and dipyridamole-induced changes in Tei index (B −0.425, P = .007). A severely decreased CFR < 1.5 was observed in 52% of the patients. E/E' ratio (B 10.84, P = .014) was the single independent predictor of severely decreased CFR. Conclusions: In end-stage CKD patients on hemodialysis without known cardiovascular disease, impaired coronary vascular function was prevalent and related to increased left ventricular wall thickness, increased filling pressures, and dipyridamole-induced deteriorated myocardial function independently of the presence of wall-motion abnormalities. Further studies are required to clarify the prognostic role of dipyridamole-induced cardiac changes in hemodialysis patients. K E Y W O R D S coronary flow reserve, diastolic function, echocardiography, end-stage renal disease, left ventricular function | 537 PAPAMICHAIL et AL.

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“…However, despite the advances in hemodialysis technology, the mortality and morbidity of ESRD patients on MHD remains high and the quality of life of these patients is poor [2]. Cardiovascular disease is a major complication of ESRD that is caused by metabolic and hemodynamic changes due to ESRD and is associated with high mortality [3,4], accounting for approximately 50% of hemodialysis patient deaths [5]. Left ventricular (LV) dysfunction is a critical indicator of cardiac dysfunction and an early clinical manifestation of LV hypertrophy.…”

Section: Introductionmentioning

confidence: 99%

Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients

Liu

Yan

Fan

et al. 2020

BMC Cardiovasc Disord

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Background: This study investigated the value of layer-specific strain analysis by two-dimensional speckle tracking echocardiography (2D-STE) for evaluating left ventricular (LV) systolic function and synchrony in maintenance hemodialysis (MHD) patients. Methods: A total of 34 MHD patients and 35 healthy controls were enrolled in this study. Dynamic images were collected at the LV apical long-axis, the four-and two-chamber, and the LV short-axis views at the basal, middle, and apical segments. The layer-specific speckle tracking (LST) technique was used to analyze the longitudinal strain (LS) and circumferential strain (CS) of LV sub-endocardium, mid-myocardium, sub-epicardium, global longitudinal strain (GLS), global circumferential strain (GCS), the LV 17 segment time to peak LS (TTP), and the peak strain dispersion (PSD). The differences in these parameters were compared between control and MHD groups, and the correlation between PSD and each LS parameter was examined. The receiver operator characteristic (ROC) curve was used to evaluate the efficacy of three myocardial layer LS and CS in the assessment of LV systolic dysfunction in MHD patients. Results: MHD patients had comparable left ventricular ejection fraction (LVEF), but significantly smaller LV GLS, GCS, and three-layer LS and CS compared to the control group. The three myocardial layer LS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD patients compared to the normal subjects, while the three myocardial layer CS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD patients compared to the normal subjects, except for the sub-endocardium of the middle and apex segment. MHD patients had significantly higher TTP of LV 17 segments and PSD compared to controls, and had delayed peak time in most segments. In addition, PSD of MHD patients was positively correlated with sub-endocardial and mid-myocardial LS and GLS, but not with sub-epicardial LS. The area under the curves (AUCs) of sub-endocardial, mid-myocardial, and sub-epicardial LS in MHD patients were 0.894, 0.852, and 0.870, respectively; the AUCs of sub-epicardial, mid-myocardial, and sub-endocardial CS were 0.852, 0.837, and 0.669, respectively. Conclusions: LST may detect early changes of all three-layer LS and CS and PSD in MHD patients, and is therefore a valuable tool to diagnose LV systolic dysfunction in MHD patients.

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Hemodialysis‐induced cardiovascular disease

Cited by 129 publications

References 120 publications

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Impaired coronary microcirculation is associated with left ventricular diastolic dysfunction in end‐stage chronic kidney disease patients

Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients

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