Dialysis-associated morbidity, ultrafiltration, and cardiovascular variables in children with HIV infection

R. Gordillo, Marcela Del Rio, R. P. Woroniecki

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Children infected with HIV on maintenance hemodialysis (HD) have increased mortality with adequate single pool Kt/V, as compared to non-HIV children on HD. It is unclear if HIV subjects on HD have similar dialysis-associated morbidity (DAM) and blood volume changes (dBV) as non-HIV subjects. It is also unclear how those variables are related to left ventricular mass index (LVMI), shortening fraction (SF), pre-and postdialysis blood pressure and mortality. Methods: We investigated the relationship between LVMI, SF and dBV and DAM using noninvasive monitoring of hematocrit in HIV vs. non-HIV subjects and their association with mortality. We used a cross-sectional study design and analyzed 18 pediatric subjects (9 had vertically transmitted HIV) on HDover a 17-month period. HIVsubjects tolerated fluid removal during HD treatments as well as non-HIV subjects. Results: In our study we confirmed an association of LVMI with DAM in subjects on HD. We found that HIV subjects who did not survive had a significantly lower SF and similar viral load as compared to subjects who survived. Conclusions: Noninvasive monitoring of hematocrit in HIV subjects with compromised heart function allows effective ultrafiltration. Routine echocardiography should be periodically performed in allHIV-infected children on renal replacement therapy because subclinical abnormalities, i.e. increased LVMI or reduced SF in this population can be predictors of mortality.

Original languageEnglish (US)
Pages (from-to)434-439
Number of pages6
JournalClinical Nephrology
Volume75
Issue number5
DOIs
StatePublished - 2011

Fingerprint

Ultrafiltration
HIV Infections
Dialysis
Renal Dialysis
HIV
Morbidity
Mortality
Blood Volume
Hematocrit
Renal Replacement Therapy
Viral Load
Echocardiography
Cross-Sectional Studies
Maintenance
Pediatrics
Blood Pressure
Population

Keywords

  • Dialysis associated morbidity
  • LVMI
  • Mortality in HIV

ASJC Scopus subject areas

  • Nephrology

Cite this

Dialysis-associated morbidity, ultrafiltration, and cardiovascular variables in children with HIV infection. / Gordillo, R.; Del Rio, Marcela; Woroniecki, R. P.

In: Clinical Nephrology, Vol. 75, No. 5, 2011, p. 434-439.

Research output: Contribution to journalArticle

@article{b7c59cdf544649c387ee2a5805c7a581,
title = "Dialysis-associated morbidity, ultrafiltration, and cardiovascular variables in children with HIV infection",
abstract = "Children infected with HIV on maintenance hemodialysis (HD) have increased mortality with adequate single pool Kt/V, as compared to non-HIV children on HD. It is unclear if HIV subjects on HD have similar dialysis-associated morbidity (DAM) and blood volume changes (dBV) as non-HIV subjects. It is also unclear how those variables are related to left ventricular mass index (LVMI), shortening fraction (SF), pre-and postdialysis blood pressure and mortality. Methods: We investigated the relationship between LVMI, SF and dBV and DAM using noninvasive monitoring of hematocrit in HIV vs. non-HIV subjects and their association with mortality. We used a cross-sectional study design and analyzed 18 pediatric subjects (9 had vertically transmitted HIV) on HDover a 17-month period. HIVsubjects tolerated fluid removal during HD treatments as well as non-HIV subjects. Results: In our study we confirmed an association of LVMI with DAM in subjects on HD. We found that HIV subjects who did not survive had a significantly lower SF and similar viral load as compared to subjects who survived. Conclusions: Noninvasive monitoring of hematocrit in HIV subjects with compromised heart function allows effective ultrafiltration. Routine echocardiography should be periodically performed in allHIV-infected children on renal replacement therapy because subclinical abnormalities, i.e. increased LVMI or reduced SF in this population can be predictors of mortality.",
keywords = "Dialysis associated morbidity, LVMI, Mortality in HIV",
author = "R. Gordillo and {Del Rio}, Marcela and Woroniecki, {R. P.}",
year = "2011",
doi = "10.5414/CN106527",
language = "English (US)",
volume = "75",
pages = "434--439",
journal = "Clinical Nephrology",
issn = "0301-0430",
publisher = "Dustri-Verlag Dr. Karl Feistle",
number = "5",

}

TY - JOUR

T1 - Dialysis-associated morbidity, ultrafiltration, and cardiovascular variables in children with HIV infection

AU - Gordillo, R.

AU - Del Rio, Marcela

AU - Woroniecki, R. P.

PY - 2011

Y1 - 2011

N2 - Children infected with HIV on maintenance hemodialysis (HD) have increased mortality with adequate single pool Kt/V, as compared to non-HIV children on HD. It is unclear if HIV subjects on HD have similar dialysis-associated morbidity (DAM) and blood volume changes (dBV) as non-HIV subjects. It is also unclear how those variables are related to left ventricular mass index (LVMI), shortening fraction (SF), pre-and postdialysis blood pressure and mortality. Methods: We investigated the relationship between LVMI, SF and dBV and DAM using noninvasive monitoring of hematocrit in HIV vs. non-HIV subjects and their association with mortality. We used a cross-sectional study design and analyzed 18 pediatric subjects (9 had vertically transmitted HIV) on HDover a 17-month period. HIVsubjects tolerated fluid removal during HD treatments as well as non-HIV subjects. Results: In our study we confirmed an association of LVMI with DAM in subjects on HD. We found that HIV subjects who did not survive had a significantly lower SF and similar viral load as compared to subjects who survived. Conclusions: Noninvasive monitoring of hematocrit in HIV subjects with compromised heart function allows effective ultrafiltration. Routine echocardiography should be periodically performed in allHIV-infected children on renal replacement therapy because subclinical abnormalities, i.e. increased LVMI or reduced SF in this population can be predictors of mortality.

AB - Children infected with HIV on maintenance hemodialysis (HD) have increased mortality with adequate single pool Kt/V, as compared to non-HIV children on HD. It is unclear if HIV subjects on HD have similar dialysis-associated morbidity (DAM) and blood volume changes (dBV) as non-HIV subjects. It is also unclear how those variables are related to left ventricular mass index (LVMI), shortening fraction (SF), pre-and postdialysis blood pressure and mortality. Methods: We investigated the relationship between LVMI, SF and dBV and DAM using noninvasive monitoring of hematocrit in HIV vs. non-HIV subjects and their association with mortality. We used a cross-sectional study design and analyzed 18 pediatric subjects (9 had vertically transmitted HIV) on HDover a 17-month period. HIVsubjects tolerated fluid removal during HD treatments as well as non-HIV subjects. Results: In our study we confirmed an association of LVMI with DAM in subjects on HD. We found that HIV subjects who did not survive had a significantly lower SF and similar viral load as compared to subjects who survived. Conclusions: Noninvasive monitoring of hematocrit in HIV subjects with compromised heart function allows effective ultrafiltration. Routine echocardiography should be periodically performed in allHIV-infected children on renal replacement therapy because subclinical abnormalities, i.e. increased LVMI or reduced SF in this population can be predictors of mortality.

KW - Dialysis associated morbidity

KW - LVMI

KW - Mortality in HIV

UR - http://www.scopus.com/inward/record.url?scp=79958747537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958747537&partnerID=8YFLogxK

U2 - 10.5414/CN106527

DO - 10.5414/CN106527

M3 - Article

VL - 75

SP - 434

EP - 439

JO - Clinical Nephrology

JF - Clinical Nephrology

SN - 0301-0430

IS - 5

ER -