title: Hemodialysis and hemodiafiltration differently modulate left ventricular diastolic function.
abstract: BACKGROUND
  Renal replacement therapy may have a favorable effect on diastolic left ventricular function, but it is not clear whether hemodiafiltration is superior to hemodialysis in this field. Nitric oxide (NO) and asymmetric dimethylarginine (ADMA) may play a role in the changes of intracardiac hemodynamics, but it is not clear whether the different renal replacement methods have disparate influence on the metabolism of these materials.
  
  
  METHODS
  Thirty patients on renal replacement therapy were investigated. First, data was analyzed while patients received hemodiafiltration over a period of three months. Then, the same patients were evaluated during treatment with hemodialysis for at least another three months. Echocardiography was performed before and after renal replacement therapy.
  
  
  RESULTS
  No significant difference was found in the volume removals between hemodialysis and hemodiafiltration. The left atrial diameter and transmitral flow velocities (E/A) decreased significantly only during hemodiafiltration. A positive correlation was observed between the left atrial diameter and E/Ea representing the left ventricular pressure load during hemodiafiltration. Significant correlations between NO and A and E/A were observed only in the case of hemodiafiltration.
  
  
  CONCLUSIONS
  Hemodiafiltration has a beneficial effect on echocardiographic markers representing left ventricular diastolic function. This could be attributed to the differences between the dynamics of volume removal and its distribution among liquid compartments.
authors.affiliation: Division of Nephrology, Department of Medicine, Medical and Health Science Center, University of Debrecen, Pf. 19, Nagyerdei Kr. 98, Debrecen 4012, Hungary.
authors.forename: Arpád
authors.initials: A
authors.lastname: Czifra
authors.forename: Alida
authors.initials: A
authors.lastname: Páll
authors.forename: Julianna
authors.initials: J
authors.lastname: Kulcsár
authors.forename: Kitti
authors.initials: K
authors.lastname: Barta
authors.forename: Attila
authors.initials: A
authors.lastname: Kertész
authors.forename: György
authors.initials: G
authors.lastname: Paragh
authors.forename: István
authors.initials: I
authors.lastname: Lőrincz
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Jenei
authors.forename: Anupam
authors.initials: A
authors.lastname: Agarwal
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Zarjou
authors.forename: József
authors.initials: J
authors.lastname: Balla
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabó
mesh_terms: D000368:Aged; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000378:metabolism*; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D006435:Renal Dialysis / Q000379:methods; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D009569:Nitric Oxide
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