THE EFFECT OF EXTRACORPOREAL HIGH BLOOD-FLOW RATE ON LEFT-VENTRICULARFUNCTION DURING HEMODIALYSIS - AN ECHOCARDIOGRAPHIC STUDY

The effect of increased extracorporeal blood flow rate on left ventric ular (LV) function has been studied during volume-controlled bicarbona te hemodialysis. Ten stable patients on chronic hemodialysis, with a m ean age of 28 years (range 19-38) were studied using two-dimensional a nd Doppler echocardiography. The mean time on hemodialysis was 32 mont hs (range 3-60). All patients were investigated during three dialysis sessions on the first day of the week for 3 consecutive weeks. The blo od flow rate was chosen randomly as 250, 350, or 450 cc/min. Apart fro m the time of hemodialysis and blood flow rate, other parameters of th e hemodialysis were kept stable during all three sessions. Echocardiog raphic studies were done before, at mid dialysis, and during the last 15 min of each dialysis session. The following parameters were evaluat ed: heart rate, mean blood pressure. shortening fraction, ejection fra ction, cardiac output, and pre-ejection period/LV ejection time ratio. The changes of the measured cardiac parameters at the beginning, midd le and end of each session were not significantly different. Furthermo re, the differences in changes between the three different sessions we re comparable. Our results indicate that an increase in dialysis blood flow rate up to 450 cc/min does not have an adverse effect on the lef t ventricle in patients on maintenance hemodialysis and with stable ca rdiovascular function.