ECHOCARDIOGRAPHIC FINDINGS IN LONG-TERM, LONG-HOUR HEMODIALYSIS-PATIENTS

This article describes the echocardiographic structural and functional findings in a cohort of 30 patients on ten or more years of uninterru pted long-hour (24 hours per week dialysis schedule) hemodialysis (mea n duration 187.7 months, range 120 to 299 months). Cardiac structural analysis was remarkable for the prevalence of LVH (76%), very rarely a symmetric (3%). Hemoglobin and (log) plasma renin activity were determ inants of the LV wall thickness ratio (r = -0.57 and 0.54, p = 0.003 a nd 0.044 respectively). Markers of systolic contractile;function were frequently normal (100% MVCFS; 85% FSI). Diastolic ventricular complia nce was abnormal in 59% of patients, Blood pressure history appeared i mportant in determining LVH, but office/ABPM measures of BP were not. Patients after parathyroidectomy (PTx) had a smaller LVPWTN (8.68 mm/m (2) without PTx cf 7.01 mm/m(2) after PTx, p = 0.036). Left ventricula r cavity size was rarely enlarged (10%), with hemoglobin (r = -0.47, p = 0.012) and PTH (r = -0.65, p <0.001) the major determinants of EDDN . Left atrial diameter was increased in 77% of patients. Cardiac valvu lar calcification was seen in 50% of patients. Our findings show that despite good BP control without recourse to antihypertensive drugs, LV H with good LV systolic function is very common in these long-survivor s.