Why the study?
Does strict fluid volume control via a salt-restricted diet reduce left ventricular hypertrophy more effectively than anti-hypertensive drugs in haemodialysis patients?
Does strict fluid volume control via a salt-restricted diet reduce left ventricular hypertrophy more effectively than anti-hypertensive drugs in haemodialysis patients?
Strict fluid volume control via salt restriction is more effective than anti-hypertensive medications at reducing left ventricular hypertrophy and dilated cardiac compartments in hemodialysis patients.
Should not yet alter antihypertensive strategies in HD; hypothesis-generating for salt restriction in LVH and needs prospective trials.
Left ventricular hypertrophy (LVH) is very common in haemodialysis patients. We measured left ventricular mass in three groups of haemodialysis patients: group A (n = 40) were normotensive and receiving a strict salt-restricted diet; group B (n = 23) were normotensive and receiving anti-hypertensive drugs; and group C (n = 43) were hypertensive despite anti-hypertensive drug treatment. The interdialytic weight gain in group B and group C was significantly higher than in group A; the mean left atrial index and left ventricular end-systolic and end-diastolic diameter indices were all higher in group B than in group A. The interventricular septum and posterior wall were significantly thicker in group B and group C than group A, resulting in a higher left ventricular mass index. Left ventricular systolic and diastolic function parameters were slightly better in group A than in the other groups. These results show that strict fluid volume control decreases blood pressure, reduces dilated cardiac compartments and corrects LVH more effectively than lowering blood pressure without correcting the volume overload.
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Günal et al. (2004) studied this question.