Abstract
Comparative studies on cardiac function were performed in 6 patients with chronic renal failure during hemodialysis (HD) and hemofiltration (HF). The cases were divided into 2 groups on the basis of the duration of HD (maintenance 3, introduction 3), and were also divided into 3 groups according to the primary disease (diabetic nephropathy 3, chronic glomerulonephritis 2, and chronic pyelonephritis 1). HD was performed with a hollow fiber dialyzer using AK-Solita as the dialysate, HF was performed with a Sartorius Hemofilter using HF-Solita as the substitution fluid.
Methods: A Swan-Ganz thermodilution catheter was inserted into the pulmonary artery and the changes in cardiac function were evaluated before, at 1 and 3 hours after starting, and at 30 minutes after ending HD and HF, respectively.
Results: 1) When the cardiac function curve was drawn with the pulmonary capillary wedge pressure (PCWP) and the left ventricular stroke work index % (SWI%) expressed as percent of the value before starting HD or HF, the changes or reductions in cardiac function were smaller during HF than during HD. 2) When the relationthip between the body weight decreasing rate (ΔBW%) and SWI% during HD and HF was investigated, SWI% tended to produce a smaller reduction during HF than during HD regardless of the value of ΔBW%, and all of the relationships between log (SWI%) and ΔBW% except in patient (case 4) revealed a high inverse correlation coefficient (HD: r=-0.83, P<0.01, HF: r=-0.75, P<0.01) for the straight line.
Conclusion: The changes or reductions in cardiac function were less during HF than during HD when judged on the basis of contractility.
