Effect of improving dialysis adequacy on the right ventricular functions

Background Right ventricular dysfunction (RVD) is a common finding in hemodialysis (HD) patients especially those who are inadequately dialyzed. The aim of this study is to evaluate the effect of improving dialysis adequacy, anemia, and hypertension treatment on the RV function in a cohort of HD patients. Patients and methods The study included 60 HD patients admitted in Mansoura University Hospital, Nephrology Unit. Assessment of patients included complete clinical evaluation, estimation of Kt/V, urea reduction rate, and RV function assessed by echocardiography; all were done at the beginning of the study and 6 months after initiation of protocols of therapy needed for improvement of dialysis adequacy, anemia, and hypertension. Tissue Doppler imaging-derived myocardial performance index was used as the main index of RVD. Results The study results revealed an increased prevalence of RVD in maintenance HD patients. Moreover, this study showed a significant improvement of the mean tissue Doppler-derived myocardial performance index in the studied patients at the end of the study (after improvement of Kt/V, anemia, and hypertension), compared with initial values at the start of the study, from 0.54±0.03 to 0.48±0.02, respectively, with significant P value of 0.001. Conclusion RVD is common among HD patients, but improving dialysis adequacy together with proper management of hypertension and anemia plays an essential role in the improvement of RVD.