Circulatory state of patients on chronic hemodialysis.
In 16 patients on chronic hemodialysis, the cardiac catheterization was performed. They had received the hemodialytic treatment for 41 months in the average. All but two cases had cardiothoracic ratio above 50%. It was 58 +/- 7% in all. The laboratory data, body weight, or the interdialytic body weight change was comparable with those of other patients with normal heart size. Pericardial effusion was denied by echocardiographic study. Cardiac index and the left ventricular stroke work index were higher than normal; 4.7 L/min/m2, and 85 +/- 31 g.m/m2 respectively. Cardiac index was higher than 3.9 L/min/m2 in 11 patients and left ventricular stroke work index was above 68 g.m/m2 (= mean value of control). The pulmonary artery wedge pressure was 16 +/- 6 mmHg and abnormally high in six patients (greater than 15 mmHg). The pulmonary artery wedge pressure was found to be correlated with the cardiac work (r = 0.53, p less than 0.02), and with the cardiothoracic ratio (r = 0.64, po less than 0.02). The present study revealed a circulatory abnormality of pulmonary congestion which may be brought by an excessive load upon the heart in the renal failure patients A further increase in the cardiac work by aggravation of anemia, retention of body fluid, or the elevation of blood pressure may easily result in an acute pulmonary edema. The reduction of the load by vasodilator may be useful for the relief of the acute rise of the pulmonary artery wedge pressure as suggested in the study of a small group in the present paper.
D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D002302:Cardiac Output; D006332:Cardiomegaly / Q000209:etiology / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D009599:Nitroprusside / Q000494:pharmacology; D011669:Pulmonary Wedge Pressure; D006435:Renal Dialysis
D009599:Nitroprusside