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JYMS : Journal of Yeungnam Medical Science

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Original articles
The impact of quality of life measured by WHOQOL-BREF on mortality in maintenance hemodialysis patients: a single center retrospective cross-sectional study
Seong Gyu Kim, In Hee Lee
J Yeungnam Med Sci. 2023;40(1):49-57.   Published online April 18, 2022
DOI: https://doi.org/10.12701/jyms.2022.00080
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  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool.
Methods
This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results.
Results
The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively.
Conclusion
QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.

Citations

Citations to this article as recorded by  
  • Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things
    Xiaoping Chen, Fei He, Yan Jiang, Xuezhen Chen, Yubing Yan
    DIGITAL HEALTH.2024;[Epub]     CrossRef
The relationship between disability and clinical outcomes in maintenance dialysis patients
Seok Hui Kang, Jun Young Do, Jun Chul Kim
Yeungnam Univ J Med. 2021;38(2):127-135.   Published online October 15, 2020
DOI: https://doi.org/10.12701/yujm.2020.00346
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  • 72 Download
  • 2 Crossref
AbstractAbstract PDF
Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods
This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results
The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion
Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Citations

Citations to this article as recorded by  
  • The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis
    Nilofar Pasyar, Mostafa Jowkar, Masoume Rambod
    BMC Nephrology.2023;[Epub]     CrossRef
  • Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
    Seung Min Chung, Jun Sung Moon, Min Cheol Chang
    Frontiers in Medicine.2021;[Epub]     CrossRef
Improvement of catheter-related outcomes after application of tunneled cuffed hemodialysis catheter insertion without fluoroscopy
Seok Hui Kang, Jun Young Do
Yeungnam Univ J Med. 2020;37(3):186-193.   Published online March 17, 2020
DOI: https://doi.org/10.12701/yujm.2019.00465
  • 5,257 View
  • 106 Download
AbstractAbstract PDF
Background
Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion.
Methods
We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed.
Results
Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload.
Conclusion
Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.
Original Article
Follow-up of thyroid ultrasonography in patients with hemodialysis
Hyun Jung Kim, Bo Ra Kim, Yeong Mi Seo, Yoon Young Cho, Jong Ha Baek, Kyong Young Kim, Soo Kyung Kim, Seung Hoon Woo, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm
Yeungnam Univ J Med. 2017;34(1):69-74.   Published online June 30, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.1.69
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  • 17 Download
AbstractAbstract PDF
BACKGROUND
Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.
Case Reports
Severe ileus after colonoscopy in a patient on peritoneal dialysis
Sang Un Kim, Su Hee Kim, So Yoon Hwang, Ryang Hi Kim, Ji Young Choi, Jang Hee Cho, Chan Duck Kim, Yong Lim Kim, Sun Hee Park
Yeungnam Univ J Med. 2017;34(1):119-122.   Published online June 30, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.1.119
  • 1,750 View
  • 8 Download
AbstractAbstract PDF
Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.
Complete atrioventricular block during tunneled cuffed hemodialysis catheter insertion in a patient with pre-existing left bundle branch block.
Eun Woo Choi, Ji Yoon Jung, Jun Huck Su, Sae Huyn Park, Kyu Hyang Cho, Kyung Woo Yoon, Jong Won Park, Jun Young Do, Seok Hui Kang
Yeungnam Univ J Med. 2015;32(2):152-154.   Published online December 31, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.2.152
  • 1,896 View
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AbstractAbstract PDF
Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient.
Yo Han Jeong, Jun Young Do, Mun Ju Hwang, Min Jung Kim, Min Geun Gu, Byung Sam Park, Jung Eun Choi, Tae Woo Kim
Yeungnam Univ J Med. 2014;31(1):25-27.   Published online June 30, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.1.25
  • 1,689 View
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  • 1 Crossref
AbstractAbstract PDF
Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.

Citations

Citations to this article as recorded by  
  • Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience
    H.-W. Kou, C.-N. Yeh, C.-Y. Tsai, J.-T. Hsu, S.-Y. Wang, C.-W. Lee, M.-C. Yu, T.-L. Hwang
    Hernia.2021; 25(5): 1317.     CrossRef
Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm.
Soon Young Kim, Tae Jun Kim, Seong Kyun Na, Seung Ah Park, Dong Min Jung, Yong Kyun Kim, Sang Ho Jo
Yeungnam Univ J Med. 2014;31(1):17-20.   Published online June 30, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.1.17
  • 1,599 View
  • 6 Download
AbstractAbstract PDF
Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.
A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due to Stenotrophomonas maltophilia Using Antibiotic Combination.
Hee Sung Ko, Ah Ran Choi, Tae Hoon Kim, Chan Hee Kyung, Jang Ho Cho, Yong Hoon Kim, Jung Eun Lee
Yeungnam Univ J Med. 2013;30(2):109-111.   Published online December 31, 2013
DOI: https://doi.org/10.12701/yujm.2013.30.2.109
  • 1,699 View
  • 5 Download
AbstractAbstract PDF
Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a major complication of peritoneal dialysis (PD) and leads to the discontinuation of PD. Despite its limited pathogenicity, CAPD peritonitis caused by Stenotrophomonas maltophilia (S. maltophilia), an important nosocomial pathogen that is present in nature and is usually associated with plastic indwelling devices. Infection of S. maltophilia is associated with a poor prognosis, including inability to maintain the CAPD catheter, because of its resistance to multiple antibiotics. We report a case of CAPD peritonitis due to S. maltophilia that was treated successfully using oral Trimethoprim-sulfame-thoxazole and intraperitoneal Ticarcillin/clavulanate without removing the dialysis catheter.
Two Cases of Spinal Epidural Abscess in Hemodialysis Patients.
Young Hwan Kim, Jin Taek Yoo, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Mun Jang, Jung Choi
Yeungnam Univ J Med. 2013;30(1):36-38.   Published online June 30, 2013
DOI: https://doi.org/10.12701/yujm.2013.30.1.36
  • 1,693 View
  • 3 Download
AbstractAbstract PDF
While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.
A Case of Neurotoxicity Induced by Valaciclovir in a Continuous Ambulatory Peritoneal Dialysis Patient.
Joon Seok Kim, Jee Eun Yang, Bo Young Lee, Seohyun Lee, Hee Jung Park, Sunpyo Lee, Sang Koo Lee
Yeungnam Univ J Med. 2012;29(2):121-124.   Published online December 31, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.2.121
  • 1,686 View
  • 6 Download
  • 2 Crossref
AbstractAbstract PDF
Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

Citations

Citations to this article as recorded by  
  • Comparison of Renal Function Indicators According to Hydration Volume in Patients Receiving Intravenous Acyclovir With CNS Infection
    Sanghee Kim, Youngsoon Byun
    Biological Research For Nursing.2015; 17(1): 55.     CrossRef
  • Valacyclovir-Induced Neurotoxicity in a Maintenance Hemodialysis Patient
    June Seong Hwang, Hyo Yoep Song, Hoon Gil Jo, Song I Lee, Byung Hun Lim, Jung Sub Song, Seon Ho Ahn
    Journal of the Korean Geriatrics Society.2014; 18(2): 85.     CrossRef
A Case of Exit-Site Infection and Abscess by Mycobacterium Abscessus in a CAPD Patient.
Sun Young Jung, Ji Hoon Na, Kyu Hyang Cho, Jong Won Park, Jun Young Do, Kyeung Woo Yun, In Wook Song, Jeong Hwan Cho, Chang Woo Son
Yeungnam Univ J Med. 2009;26(2):137-143.   Published online December 31, 2009
DOI: https://doi.org/10.12701/yujm.2009.26.2.137
  • 1,588 View
  • 2 Download
  • 2 Crossref
AbstractAbstract PDF
Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.

Citations

Citations to this article as recorded by  
  • A Case Report ofMycobacterium abscessusPeritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis
    Seon Joo Kang, Heungsoo Kim, Kyoung Un Park, Young Ae Lim, Wee Gyo Lee
    Annals of Clinical Microbiology.2013; 16(2): 101.     CrossRef
  • A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due toStenotrophomonas maltophiliaUsing Antibiotic Combination
    Hee Sung Ko, Ah Ran Choi, Tae Hoon Kim, Chan Hee Kyung, Jang Ho Cho, Yong Hoon Kim, Jung Eun Lee
    Yeungnam University Journal of Medicine.2013; 30(2): 109.     CrossRef
A Case of Pneumatosis Intestinalis in Peritoneal Dialysis Peritonitis.
Sun Young Jung, Ji Hun Na, Yun Jung Choi, Sung Ae Koh, Ku Hyang Choi, Jong Won Park, Jun Young Do, Kyeng Woo Yun
Yeungnam Univ J Med. 2009;26(1):49-55.   Published online June 30, 2009
DOI: https://doi.org/10.12701/yujm.2009.26.1.49
  • 1,618 View
  • 3 Download
AbstractAbstract PDF
Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmental resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.
Original Articles
The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis.
Hang Jae Jung, Sung Hwa Bae, Jun Bum Park, Kyoo Hyang Jo, Young Jin Kim, Jun Young Do, Kyung Woo Yoon
Yeungnam Univ J Med. 1999;16(2):333-341.   Published online December 31, 1999
DOI: https://doi.org/10.12701/yujm.1999.16.2.333
  • 1,328 View
  • 1 Download
AbstractAbstract PDF
BACKGROUND
AND METHODS: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). RESULTS: The results were as follows: 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantlydecreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.005). 3) After changing the modality from hemodialysis to peritoneal dialysis. MAP(mmHg, from 107.1+/-4.5 to 98.6+/-8.8, p<0.05), antihypertensive drug requirements(from 5.6+/-2.6, to 2.0+/-2.5, p<0.01) and erythropoietin dosages(Uint/week, from 4600+/-2660 to 2000+/-1630, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V. weekly creatinine clearance) was not revealed. CONCLUSION: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.
Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study.
Dong Oh Kang, Du Ha Lee, Hyun Seo Kim, Hyun Su Kim, Sung Rok Kim, Jong Seon Park
Yeungnam Univ J Med. 1999;16(2):309-317.   Published online December 31, 1999
DOI: https://doi.org/10.12701/yujm.1999.16.2.309
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AbstractAbstract PDF
BACKGROUND
Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function, we performed M-mode and Doppler echocardiopraphic studies before and after hemodialysis. METHODS: The study population consisted of 30 patients(15 patients were male, mean age 45+/-10 years) with CRF on maintenance henodialysis. They have normal left ventricular systolic function(Fractional shortening > 30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction(EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxaion time(IVRT), deceleration time(DT), and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance(IMP) was calculated from each of the Doppler velocity indices. RESULTS: The weight reduction after hemodialysis was 2.1+/-1.0kg(p<0.0001). After hemodialysiss, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant in IVRT and IMP(p<0.05, p<0.0001) were noted. CONCLUSTION: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And and increased IMP suggests that diastolic function may be aggravated after gemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

JYMS : Journal of Yeungnam Medical Science