Key result
Left ventricular hypertrophy is present in 75% of hemodialysis patients and is a significant cause of diastolic dysfunction, highlighting the need for early detection and timely therapy.
Early detection of high-risk patients for diastolic dysfunction enables timely application of adequate therapy, providing a high degree of survival in hemodialysis patients.
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Supports LVH screening in hemodialysis; leaves open whether early therapy improves survival in prospective trials.
Cardiovascular diseases are the leading cause of death in patients on hemodialysis. Cardiovascular mortality rate in these patients is approximately 9% per year, with the highest prevalence of left ventricular hypertrophy, ischemic heart disease and congestive heart failure among cardiovascular complications. The aim of this study was to assess cardiovascular risk factors, pathogenetic mechanisms for the development of diastolic dysfunction of heart, and point to clinical importance of early detection and timely application of adequate therapy in patients with diastolic dysfunction. Expert works and clinical studies dealing with diagnostics and therapy for diastolic dysfunction in population of patients on hemodialysis were analyzed. Left ventricular hypertrophy was present in 75% of patients on hemodialysis. Risk factors for development of hypertrophy of the left ventricle in patients on hemodialysis include: increased shunt blood flow, anaemia, sodium and water retention, hypertension, oxidative stress, microinflammation, hyperhomocysteinemia and secondary hyperparathyroidism. Left ventricular hypertrophy is an important cause of diastolic dysfunction of left ventricle in this population. Diagnostic strategy for early detection of high-risk patients for the development of asymptomatic diastolic dysfunction include: echocardiography examination, tests for proving coronary artery disease, as well as tests for myocardial function examination. Early detection of patients with high risk for the development of diastolic dysfunction enables timely application of adequate therapy strategy which provides a high degree of survival in patients on hemodialysis.
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Nedeljković et al. (2014) conducted a review in Diastolic heart failure in patients on hemodialysis. Diagnostics and therapy for diastolic dysfunction was evaluated. Left ventricular hypertrophy is present in 75% of hemodialysis patients and is a significant cause of diastolic dysfunction, highlighting the need for early detection and timely therapy.
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