Effect of anemia on cardiac disorders in pre-dialysis patients immediately before starting hemodialysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Michio Kuwahara Soichiro Iimori Tamaki Kuyama Wataru Akita Yoshihiro Mori Tomoki Asai Yusuke Tsukamoto Susumu Adachi Tatemitsu Rai S
- چاپ و سال / کشور: 2011
Description
Introduction Anemia is a common complication of patients with chronic kidney disease (CKD), which not only lowers their quality of life but also potentially causes cardiovascular diseases such as congestive heart failure and coronary heart disease, and accelerates the progression of renal dysfunction. Methods Pre-dialysis patients were assigned to groups A, B, C or D based on hemoglobin levels of B8.9 (n = 48), 9.0–9.9 (n = 63), 10–10.9 (n = 53), and C11.0 g/dL (n = 39), respectively. Cardiac function was estimated using echocardiography to clarify the relationship between anemia and cardiac disorders in patients with CKD immediately before starting hemodialysis. Results Left ventricular ejection fraction (LVEF) was significantly higher in group D than in groups A and B. The fractions with an LVEF of less than 50% were 16.7, 4.8, 1.9, and 0% in groups A, B, C, and D, respectively. Posterior wall thickness was statistically thicker and the deceleration time of the early diastolic wave was longer in groups A and B, respectively, than in groups C and D. The left ventricular mass index in group D was significantly lower than in any other groups. Conclusion Anemia in pre-dialysis patients with CKD is a probable cause of impaired left ventricular systolic function and progressive left ventricular hypertrophy. Our results suggest that Hb levels should be maintained at [11 g/dL by EPO administration from the perspective of protecting cardiac function, although the upper limit of the target Hb level was undetermined.
Clin Exp Nephrol (2011) 15:121–125, Received: 6 March 2010 / Accepted: 29 September 2010 / Published online: 11 November 2010 Japanese Society of Nephrology 2010
