Right ventricular dysfunction in patients with end-stage renal disease

Francesco Paneni, Mario Gregori, Giuseppino Massimo Ciavarella, Sebastiano Sciarretta, Luciano De Biase, Laura Marino, Giuliano Tocci, Francesco Principe, Alessandro Domenici, Remo Luciani, Giorgio Punzo, Paolo Menè, Massimo Volpe

Research output: Contribution to journalArticle

Abstract

Background: While chronic dialysis treatment has been suggested to increase pulmonary pressure values, right ventricular dysfunction (RVD) is a major cause of death in patients with end-stage renal disease. We investigated the impact of different dialysis treatments on right ventricular function. Methods: We examined 220 subjects grouped as follows: healthy controls (n = 100), peritoneal dialysis (PD; n = 26), hemodialysis (HD) with radial arteriovenous fistula (AVF; n = 62), and HD with brachial AVF (n = 32). Echocardiography including tissue Doppler imaging (TDI) of the right ventricle was performed in all patients. Results: Pulmonary pressure values progressively rose from controls across the 3 dialysis groups (21.7 ± 6.8, 29.7 ± 6.7, 37.9 ± 6.7 and 40.8 ± 6.6 mm Hg, respectively; p <0.001). TDI indices of right ventricular function were more impaired in HD patients, particularly in those with brachial AVF. RVD, assessed by TDI myocardial performance index, was higher in HD patients compared with PD patients (71.3 vs. 34.6%, p <0.001). Moreover, the prevalence of RVD further increased in patients with brachial AVF compared with the radial access (90.6 vs. 61.3%, p <0.001). Conclusions: Compared to DP, HD increases the risk of RVD, particularly in the presence of brachial AVF. TDI may detect early functional failure of the right ventricle in HD patients.

Original languageEnglish
Pages (from-to)432-438
Number of pages7
JournalAmerican Journal of Nephrology
Volume32
Issue number5
DOIs
Publication statusPublished - Nov 2010

Keywords

  • Arteriovenous fistula
  • Dialysis
  • Pulmonary hypertension
  • Right ventricular dysfunction

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Paneni, F., Gregori, M., Ciavarella, G. M., Sciarretta, S., De Biase, L., Marino, L., Tocci, G., Principe, F., Domenici, A., Luciani, R., Punzo, G., Menè, P., & Volpe, M. (2010). Right ventricular dysfunction in patients with end-stage renal disease. American Journal of Nephrology, 32(5), 432-438. https://doi.org/10.1159/000320755