Key result
Higher ultrafiltration rate linked to ~5-fold higher odds of increased left ventricular mass index.
Why the study?
Hemodialysis patients have a high burden of cardiovascular diseases and arrhythmia-related mortality, but the association of ultrafiltration rate with left heart structure and arrhythmias is unclear.
Does a higher ultrafiltration rate (≥ 10 mL/kg/h) increase structural remodeling of the left heart and arrhythmias in hemodialysis patients?
Cross-Sectional (n=75)
Does a higher ultrafiltration rate (≥ 10 mL/kg/h) increase structural remodeling of the left heart and arrhythmias in hemodialysis patients?
Odds Ratio: 4.7619 (95% CI 1.6825–13.4774)
Absolute Event Rate: 138.47% vs 116.04%
p-value: p=0.0033
In hemodialysis patients, a higher ultrafiltration rate (≥ 10 mL/kg/h) is associated with adverse structural remodeling of the left heart, including increased left atrial volume and left ventricular mass indices.
UFR was associated with left heart parameters and arrhythmias in HD; hypothesis-generating, prospective trials needed before practice change.
Background/aim: Hemodialysis patients face a high burden of cardiovascular diseases, which account for over 40% of mortality in this population. In these patients, approximately two-thirds of cardiovascular deaths are due to arrhythmia. The aim of this study was to determine whether the ultrafiltration rate is associated with morphological and functional parameters of the left heart and arrhythmias. Methods: This work was a cross-sectional observational clinical study, with 75 hemodialysis patients. Patients were divided into two groups based on ultrafiltration rate (UFR): higher-UFR group, ultrafiltration rate ≥ 10 mL/kg/h (n = 37); lower-UFR group, ultrafiltration rate < 10 mL/kg/h (n = 38). All patients were analyzed for myocardial morphological and functional parameters and arrhythmias. Results: Statistically significant higher values were observed for the left atrium diameter (LAD) (47.56 ± 4.82 vs. 44.75 ± 2.33 mm, p = 0.0019), the left atrial volume index (LAVI) (43.28 ± 7.13 vs. 36.43 ± 8.52 mL/m2, p = 0.0003), and the left ventricular mass index (LVMI) (138.47 ± 29.32 vs. 116.04 ± 31.64 g/m2, p = 0.0021) in the higher-UFR group. UFR was associated with LAD (OR: 3.6000, 95% CI: 1.3780–9.4053, p = 0.0089), LAVI (OR: 4.1067, 95% CI: 1.5478–10.8956, p = 0.0045), and LVMI (OR: 4.7619, 95% CI: 1.6825–13.4774, p = 0.0033). The frequency of ventricular and supraventricular arrhythmias was similar between the analyzed patient groups. Conclusions: Higher UFR was associated with structural changes in the left heart (LAVI, LAD, and LVMI), but not with other echocardiographic parameters or arrhythmias in hemodialysis patients.
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Brkić et al. (2026) conducted a cross-sectional in Hemodialysis (n=75). Higher ultrafiltration rate (≥ 10 mL/kg/h) vs. Lower ultrafiltration rate (< 10 mL/kg/h) was evaluated on Left ventricular mass index (LVMI) (OR 4.7619, 95% CI 1.6825-13.4774, p=0.0033). Higher ultrafiltration rate (≥ 10 mL/kg/h) was significantly associated with increased left ventricular mass index (OR 4.76; 95% CI 1.68-13.48; p=0.0033) and other structural changes.
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