Intensive Hemodialysis in Patients with ESRD Improves Cardiac Function Through Inflammatory Regulation.
- Author:
Chang Su BOO
1
;
Young Seok WOO
;
Jae Won LEE
;
Gang Jee KO
;
Sang Kyung JO
;
Won Yong CHO
;
Hyoung Kyu KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Korea University, The Institute of Renal Disease, Seoul, Korea. wonyong@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Renal dialysis;
Heart failure;
Systolic;
Ventricular ejection fraction;
Inflammation;
Cytokines
- MeSH:
Arterial Pressure;
Cytokines;
Dialysis;
Echocardiography;
Heart Failure;
Heart Ventricles;
Humans;
Imidazoles;
Inflammation;
Interleukin-10;
Kidney Failure, Chronic;
Nitro Compounds;
Prospective Studies;
Pulmonary Edema;
Renal Dialysis;
Stroke Volume;
Tumor Necrosis Factor-alpha
- From:Korean Journal of Nephrology
2008;27(3):333-340
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: CHF is a life threatening acute complication in ESRD populations. An intensive hemodialysis (HD) has been effective in reducing intravascular volume and in removing uremic toxin with improved systolic function. Although recent progress has identified an inflammation as an important contributor to the pathogenesis of CVD, the effect of intensive HD on inflammatory parameters and left ventricle (LV) systolic dysfunction is not clear. The purpose of this study is to examine the effect of intensive HD on LV systolic function and serum cytokines levels. METHODS: Among ESRD patients who underwent dialysis and developed acute pulmonary edema due to LV systolic dysfunction were enrolled. Intensive HD consisted of daily 4 hours HD for 7 consecutive days. Data were prospectively collected and 2-D echocardiography was done before and after intensive HD. Serum levels of TNF-alpha and IL-10 were compared and lipopolysaccharide (LSP)-stimulated of these cytokines were measured. RESULTS: After intensive HD, weight and mean arterial blood pressure decreased significantly and ejection fraction (EF) increased significantly. Serum IL-10 and TNF-alpha levels decreased significantly after intensive HD. In contrast, LPS stimulated production of these cytokines increased significantly after intensive HD. The difference of CRP between after HD and before HD was negatively correlated with the difference of EF. CONCLUSION: In ESRD patients with acute LV dysfunction, intensive HD significantly improved EF and restored the immune responsiveness. These results suggest that intensive HD has the advantage of improving EF through modulating inflammation and correcting immune dysfunction in ESRD patients with acute LV dysfunction.
