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Titolo:
Cardiac mortality prevention in uremic patients - Therapeutic strategies with particular attention to complete correction of renal anemia
Autore:
Berweck, S; Hennig, L; Sternberg, C; Dingerkus, H; Ludat, K; Hampl, H;
Indirizzi:
Humboldt Univ, Med Clin, Dept Nephrol & Intens Care Med, Berlin, Germany Humboldt Univ Berlin Germany Nephrol & Intens Care Med, Berlin, Germany Kardiol Praxis Schlossstr, Berlin, Germany Kardiol Praxis Schlossstr Berlin Germany is Schlossstr, Berlin, Germany
Titolo Testata:
CLINICAL NEPHROLOGY
, volume: 53, anno: 2000, supplemento:, 1
pagine: S80 - S85
SICI:
0301-0430(200002)53:<S80:CMPIUP>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; RECOMBINANT-HUMAN-ERYTHROPOIETIN; DIALYSIS PATIENTS; DISEASE; CARDIOMYOPATHY; HEMODIALYSIS; GEOMETRY; MASS;
Keywords:
anemia; left ventricular hypertrophy; Left ventricular mass index (LVMI); cardiac mortality; cardiac morbidity; echocardiography; erythropoietin; dialysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Hampl, H KfH Kuratorium Dialyse & Nierentransplantat EV, Dialyse Zentrum, Bismarckstr 97-98, D-10625 Berlin, Germany KfH Kuratorium Dialyse & Nierentransplantat EV Bismarckstr 97-98 Berlin Germany D-10625
Citazione:
S. Berweck et al., "Cardiac mortality prevention in uremic patients - Therapeutic strategies with particular attention to complete correction of renal anemia", CLIN NEPHR, 53, 2000, pp. S80-S85

Abstract

Background: Left ventricular hypertrophy represents the major risk; factorfor cardiac mortality and morbidity, with cardiac mortality being the mostimportant determinant for survival in dialysis patients. The prevalence ofleft ventricular hypertrophy is already high at initiation of dialysis andincreases with time. Anemia is considered as the most important factor forthe development of left ventricular hypertrophy. Others already demonstrated that with partial correction of renal anemia by erythropoietin a partialregression of the left ventricular mass can be achieved. Patients and methods: the investigated the effect of complete correction of renal anemia to normal hemoglobin values of 14 g/dl (Hct 42%) on left ventricular hypertrophy by echocardiography Eight Patients entered the study 4 - 8 weeks after initiation of chronic hemodialysis with a mean hemoglobin of 9.5 +/- 1.3 g/dl). Results: Left: ventricular mass index (LVMI) dereased from 155 +/- 45 g/m(2) to 123 +/- 18g/m(2) (p < 0.05) within the observation period of 12 +/- 5 months. The results showed, that either normal left ventricular dimensions could be preserved or, if left ventricular hypertrophy was already present, complete regression was possible. Conclusion. Therefore, we propose that complete correction of renal anemia should be introduced into the therapy of dialysis patients along with strict adherence to established measures for the control of left ventricular hypertrophy: control of fluid overload and arterial hypertension and the use of ACE-inhibitors and betablockers. In addition, optimal correction of metabolic acidosis, control of the calcium-phosphate product and hyperparathyreoidism must be attempted. Thus, it should be possible to reverse left ventricular hypertrophy and its deleterious consequences in the dialysis population in order to improve survival and quality of life.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 01:17:35