ECHOCARDIOGRAPHIC EVALUATION OF THE EFFECT OF HEMODIALYSIS ON CARDIAC SIZE AND FUNCTION IN PATIENTS WITH END-STAGE RENAL-DISEASE

Twelve stable patients with end-stage renal failure maintained on hemodialysis were studied by echocardiography before and after dialysis. The left ventricular (LV) end-diastolic wall thickness, interventricular septal thickness and LV mass were increased suggesting concentric LV hypertrophy. The LV end-diastolic and end-systolic volumes, and cardiac output were increased before dialysis. Aortic root dimensions, aortic valve opening, left atrium, LV wall and septal excursions and per cent LV internal diameter shortening were normal before dialysis. Some pericardial effusion was found in 50% of the patients without any symptoms or signs. With dialysis the systolic and diastolic volumes and dimensions of the left ventricle and atrium decreased significantly as did the stroke volume. These changes were associated with a significant reduction of body weight, and thereby blood volume, induced by dialysis. The cardiac output remained unchanged despite significant reduction in the stroke volume due to an increase in heart rate.