Myocardial stunning during hemodialysis is common and predicts adverse cardiovascular outcomes, highlighting the need for optimized management strategies.
May identify high-risk hemodialysis patients; hypothesis-generating for interventions to reduce events pending prospective trials.
Heart failure and cardiovascular events are common in chronic renal failure. Hemodialysis (HD) causes significant hemodynamic changes and hypotension. New evidence based on intradialytic echocardiography demonstrates transient cardiac dysfunction or stunning in majority of chronic HD patients. Over time, this group may progress to chronic heart failure and appears to predict higher cardiovascular events and mortality. Although the exact etiology is unclear, alterations in HD technique and cardiac medications may reduce this complication. We review the current understanding of acute cardiac stunning during HD and present a systematic management algorithm to optimizing overall outcomes in this high-risk population.
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Dorairajan et al. (2010) studied this question.
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