Effect of hemodialysis on left ventricular contractility in pediatric patients with end-stage renal disease

Rhodes Jonathan, Iva A. Smolens, Amir Tejani, Myles S. Schiller

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Assessment of the effect of hemodialysis on myocardial contractility is complicated by variations in loading conditions that can occur during hemodialysis and by the prevalence of coronary artery disease among patients with chronic renal failure. Therefore, we used a load-independent index of left ventricular contractility, derived from analyses of the rate corrected velocity of circumferential fiber shortening (Vcf<inf>c</inf>)-end systolic wall stress (ESWS) relationship, to study the acute effects of hemodialysis on left ventricular function in the cases of 15 pediatric patients with end-stage renal disease. Prior to dialysis, Vcf<inf>c</inf> was appropriate for ESWS (102% ± 16% of predicted) and did not differ significantly from values obtained from a group of nine normal control subjects of similar ages (103% ± 9% of predicted), indicating that the patients’ left ventricles were functioning in a normal inotropic state. After dialysis, Vcf<inf>c</inf> increased to levels beyond those expected for ESWS (118% + 20% of predicted, P <05 versus control; P <.001 versus predialysis levels), indicating that dialysis was associated with enhancement of the left ventricle’s inotropic state. A statistically significant increase in plasma norepinephrine levels was also observed. However, the increase in the percentage of the predicted Vcf<inf>c</inf> did not correlate with observed changes in this inotropic agent or with dialysis-induced variations in body weight or levels of electrolytes, urea nitrogen, or creatinine, and firm conclusions regarding the identity of the factors responsible for the positive inotropic effect of hemodialysis could not be drawn.

Original languageEnglish (US)
Pages (from-to)545-550
Number of pages6
JournalSouthern Medical Journal
Volume86
Issue number5
StatePublished - 1993
Externally publishedYes

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Chronic Kidney Failure
Renal Dialysis
Pediatrics
Dialysis
Left Ventricular Function
Electrolytes
Heart Ventricles
Urea
Coronary Artery Disease
Creatinine
Nitrogen
Body Weight

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of hemodialysis on left ventricular contractility in pediatric patients with end-stage renal disease. / Jonathan, Rhodes; Smolens, Iva A.; Tejani, Amir; Schiller, Myles S.

In: Southern Medical Journal, Vol. 86, No. 5, 1993, p. 545-550.

Research output: Contribution to journalArticle

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