title: Echocardiography in hemodialysis patients: uses and challenges.
abstract: Patients with end-stage renal disease undergoing hemodialysis have high rates of morbidity and mortality. Cardiovascular disease accounts for almost half of this mortality, with the single most common cause being sudden cardiac death. Early detection of abnormalities in cardiac structure and function may be important to allow timely and appropriate cardiac interventions. Echocardiography is noninvasive cardiac imaging that is widely available and provides invaluable information on cardiac morphology and function. However, it has limitations. Echocardiography is operator dependent, and image quality can vary depending on the operator's experience and the patient's acoustic window. Hemodialysis patients undergo regular hemodynamic changes that also may affect echocardiographic findings. An understanding of the prognostic significance and interpretation of echocardiographic results in this setting is important for patient care. There are some emerging techniques in echocardiographic imaging that can provide more detailed and accurate information compared with conventional 2-dimensional echocardiography. Use of these novel tools may further our understanding of the pathophysiology of cardiac disease in patients with end-stage renal disease undergoing hemodialysis.
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford; Institute of Population Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester.
authors.forename: Diana Y Y
authors.initials: DY
authors.lastname: Chiu
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford; Institute of Population Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester.
authors.forename: Darren
authors.initials: D
authors.lastname: Green
authors.affiliation: Department of Cardiology, Salford Royal Hospital, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Nik
authors.initials: N
authors.lastname: Abidin
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford; Institute of Population Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester.
authors.forename: Smeeta
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford; Institute of Population Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester. Electronic address: philip.kalra@srft.nhs.uk.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Kalra
mesh_terms: D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D006435:Renal Dialysis / Q000009:adverse effects
keywords: Doppler; Echocardiography; cardiac; cardiovascular disease; dialysis; disease; echo; heart; hemodialysis; image; imaging; renal replacement therapy; ultrasound