In vitro Approach to ‘Uremic Cardiomyopathy’

Weisensee, Dirk; Löw-Friedrich, Iris; Riehle, Mathis; Bereiter‐Hahn, Jürgen; Schoeppe, W.

doi:10.1159/000187519

Cited by 41 publications

(17 citation statements)

References 23 publications

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“…Histological studies comparing controls not requiring dialysis and dialyzed patients with dilated cardiomyopathy demonstrate myocyte hypertrophy and increased interstitial fibrosis in the latter [7]. Furthermore, uremic serum can reduce myocyte contractility in vitro [8]. Recent recognition of "organ crosstalk" has focused on alternative mediators, or uremic toxins, that may be involved in the association of cardiac dysfunction with chronic renal insufficiency [2].…”

Section: Discussionmentioning

confidence: 99%

Intensive hemodialysis for cardiomyopathy associated with end-stage renal disease

et al. 2011

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Heart and kidney dysfunction often coexist, and increasing evidence supports the interaction of these two organs, as demonstrated by the clinical condition known as cardiorenal syndrome (CRS). We report a pediatric patient with end-stage renal disease (ESRD) who developed a dilated cardiomyopathy and decompensated heart failure after undergoing unilateral nephrectomy and while on maintenance peritoneal dialysis. He showed marked improvement in his cardiac function with the addition of intensive hemodialysis. We discuss the pathophysiology of cardiorenal syndrome in patients with ESRD and suggest that intensive dialysis may be an effective therapy for this condition.

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Section: Discussionmentioning

confidence: 99%

Intensive hemodialysis for cardiomyopathy associated with end-stage renal disease

et al. 2011

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“…Each line indicates each individual patient. Shaded area indicates the normal range b a provement of cardiac metabolism, 35,36 and reports exist which may histologically support the restoration of cardiac function. Autopsy findings in uremic adults without coronary artery disease have shown diffuse intermyocardiocytic fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Renal Transplantation on Cardiovascular Disorders in Dialysis Patients

et al. 1998

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The present study was conducted to evaluate the impact of successful renal transplantation against the cardiovascular risk factors of patients on maintenance dialysis in whom cardiovascular accidents are the most common cause of death. A total of 74 renal transplant patients with grafts that had been functioning well for longer than 6 months after transplantation were examined before and 6-250 months after transplantation. The mean age was 34 years and the duration after transplantation was 104 +/- 66 months. An improvement in anemia from hemoglobin level of 9.0 to 13.6 g/dl and a decrease in mean systolic blood pressure from 157 +/- 24 to 135 +/- 14 mm Hg (P < 0.001) were observed after transplantation. An elevation in RV5 + SV1 levels by 0.6 mV on electrocardiogram (P = 0.042) was seen without any change in the cardiothorathic ratio on chest X-ray. Echocardiographic measurements of six recipients revealed great improvements in the left ventricular systolic dimension and thickness of the posterior wall of the left ventricle. Moreover, the ejection fraction and fractional shortening rose significantly from 59.4% +/- 16.3% to 75% +/- 8.1%, and from 30.6% +/- 9.2% to 44.8% +/- 7.9% (P = 0.017), respectively. These findings clearly show that successful renal transplantation can significantly improve the cardiovascular function of renal patients on maintenance dialysis.

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“…CKD evokes structural and functional cardiac changes such as left ventricular hypertrophy (LVH), LV dilation, and LV systolic and diastolic dysfunction. Increased blood pressure, volume overload and in particular the uremic milieu with its toxins contribute to these alterations [2][3][4]. While cardiac changes are initially adaptive they may aggravate with progressing CKD, finally leading to cardiac failure.…”

Section: Introductionmentioning

confidence: 99%

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

Hewing

Dehn

Staeck

et al. 2016

Kidney Blood Press Res

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Background/Aims: Cardiac changes observed in chronic kidney disease patients are of multifactorial origin including chronic uremia, hemodynamics or inflammation. Restoration of renal function by kidney transplantation (KTX) may reverse cardiac changes. Novel echocardiographic methods such as speckle tracking echocardiography (STE) allow early and sensitive detection of subtle changes of cardiac parameters. We evaluated changes of cardiac structure and function after KTX by advanced echocardiographic modalities. Methods: Thirty-one KTX recipients (female n=11) were evaluated by medical examination, laboratory testing and echocardiography before and after KTX (median follow-up 19 months). Left ventricular (LV) and right ventricular (RV) diameters and function were assessed by echocardiographic standard parameters. Longitudinal 2D strain of the LV (GLPS) and left atrium (LA) was determined by 2D STE. Results: After KTX, median serum creatinine level was 1.3 mg/dl (IQR, 1.2-1.5). Systolic blood pressure decreased significantly after KTX. Echocardiography showed a significant reduction in LV end-diastolic septal and posterior wall thickness and LV mass index after KTX, which was accompanied by an improvement of GLPS. There were no relevant changes in parameters of LA (reservoir, conduit or contractile) function, LV diastolic or RV function after KTX. Conclusion: LV hypertrophy reversed after successful KTX and was accompanied by an improvement in longitudinal LV function as assessed by STE. Diastolic function and STE-derived LA function parameters did not change significantly after KTX.

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In vitro Approach to ‘Uremic Cardiomyopathy’

Cited by 41 publications

References 23 publications

Intensive hemodialysis for cardiomyopathy associated with end-stage renal disease

Intensive hemodialysis for cardiomyopathy associated with end-stage renal disease

Beneficial Effects of Renal Transplantation on Cardiovascular Disorders in Dialysis Patients

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

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