Dilated uremic cardiomyopathy in a dialysis patient cured by persistent ultrafiltration.
A patient is presented who after 2 years of hemodialysis showed all of the features of congestive cardiomyopathy to a very severe degree: dilation of all cardiac compartments, increased left ventricular mass, low ejection fraction, diastolic disturbances, third- to fourth-degree mitral and tricuspid regurgitation, ascites, and low blood pressure. All of these abnormalities gradually but completely disappeared during 5 months of persistent ultrafiltration during or between dialysis sessions. It was concluded that chronic fluid overload was a major factor in the cardiac disease of this patient. Unrecognized hidden fluid overload has long been known (but also neglected), and its prevention deserves top priority in chronic dialysis patients.
Ege University Medical School, Division of Nephrology, Bornova, Izmir, Turkey.
H
H
Töz
F
F
Ozerkan
A
A
Unsal
C
C
Soydas
E J
EJ
Dorhout Mees
D000293:Adolescent; D002311:Cardiomyopathy, Dilated / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D012720:Severity of Illness Index; D013997:Time Factors; D014462:Ultrafiltration; D014511:Uremia / Q000150:complications / Q000628:therapy*; D014883:Water-Electrolyte Imbalance / Q000150:complications* / Q000209:etiology / Q000628:therapy*