Abstract
To examine the effect of ultrafiltration (UF) per dialysis on the progression of left ventricular hypertrophy (LVH), 29 patients on regular hemodialysis therapy were retrospectively investigated using M-mode echocardiography for 2 years. The patients were divided into 3 groups by the degree of UF, which was unchanged in each patient during observation. Ten patients were group 1 (UF<1kg), 13 in group 2 (1≤UF<2kg) and 6 in group 3 (2kg≤UF). M-mode echocardiography was performed at an average of 6 months after starting hemodialysis and repeated at interval of 1 year. Mean blood pressure, hematocrit and dry weight were also evaluated as other factors influencing LVH.
In group 1, LVM was unchanged (212±66g at 6 months vs 216±79g after 1 year vs 205±102g after 2 years). In group 2, LVM increased significantly (202±62g at 6 months vs 224±84g after 1 year) (p<0.05), but no significant change was found between 1 year and 2 years (234±103g). On the other hand, in group 3, LVM increased significantly every year (194±37g at 6 months vs 254±55g after 1 year vs 283±60g after 2 years) (p<0.05). Mean blood pressure and hematocrit were unchanged in 3 the groups, but dry weight in group 1 decreased every year during observation. LV systolic function in groups 2 and 3 was maintained within normal limits in spite of the progression of LVH.
These results indicate that a lowered UF, especially less than 1kg, is important in preventing the progression of LVH in hemodialysis patients.
