DILATED UREMIC CARDIOMYOPATHY IN A DIALYSIS PATIENT CURED BY PERSISTENT ULTRAFILTRATION

A patient is presented who after 2 years of hemodialysis showed all of the features of congestive cardiomyopathy to a very severe degree: di lation of all cardiac compartments, increased left ventricular mass, l ow ejection fraction, diastolic disturbances, third- to fourth-degree mitral and tricuspid regurgitation, ascites, and low blood pressure. A ll of these abnormalities gradually but completely disappeared during 5 months of persistent ultrafiltration during or between dialysis sess ions. It was concluded that chronic fluid overload was a major factor in the cardiac disease of this patient, Unrecognized hidden fluid over load has long been known (but also neglected), and its prevention dese rves top priority in chronic dialysis patients. (C) 1998 by the Nation al Kidney Foundation, Inc.