title: Cardiovascular remodeling during long-term nocturnal home hemodialysis.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of morbidity and mortality in patients with kidney failure. Nocturnal home hemodialysis (NHD) is a form of kidney replacement therapy whereby hemodialysis is performed for at least 6-h overnight, at least 4 days per week. Little is known about the effects of NHD on cardiovascular remodeling as assessed by transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR).
  
  
  OBJECTIVE
  The primary objective of the study was to determine the long-term effects of NHD on cardiovascular remodeling using different imaging modalities over a one-year follow-up.
  
  
  RESULTS
  A total of 11 patients were included in the study (6 males, mean age 48 ± 16 years) between 2009 and 2011 inclusive at a single tertiary care center. All patients underwent TTE and CMR at baseline and after 1 year of NHD. Left ventricular mass index decreased significantly at 1 year by both TTE (152 ± 7-129 ± 8 g/m(2), p < 0.05) and CMR (162 ± 4-124 ± 4 g/m(2), p < 0.05). There was also a significant decrease in both left and right atrial volume as well as in right ventricular mass index over 1 year of follow-up. Diastolic dysfunction, graded from 0 to 4, improved from a baseline grade of 3.4 to 1.2 at 1-year follow-up.
  
  
  CONCLUSIONS
  Long-term nocturnal hemodialysis leads to favorable cardiovascular remodeling with a reduction in cavity dimensions, regression of left ventricular hypertrophy, and an improvement in diastolic function, as assessed by both TTE and CMR.
authors.affiliation: Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Tyler
authors.initials: T
authors.lastname: Friesen
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada.|Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.|Department of Radiology, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Davinder S
authors.initials: DS
authors.lastname: Jassal
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Mike
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Frederick
authors.initials: F
authors.lastname: Eng
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.|Seven Oaks General Hospital Kidney Health Program, Winnipeg, MB, Canada.
authors.forename: Claudio
authors.initials: C
authors.lastname: Rigatto
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.|Seven Oaks General Hospital Kidney Health Program, Winnipeg, MB, Canada.
authors.forename: Navdeep
authors.initials: N
authors.lastname: Tangri
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Manish M
authors.initials: MM
authors.lastname: Sood
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Karlstedt
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Sheena
authors.initials: S
authors.lastname: Premecz
authors.affiliation: Section of Nephrology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada. paulkomenda@yahoo.com.|Seven Oaks General Hospital Kidney Health Program, Winnipeg, MB, Canada. paulkomenda@yahoo.com.|University of Manitoba, Seven Oaks Hospital Renal Program, 2300 Mcphillips Street, 2PD12, Winnipeg, MB, R2V 3M3, Canada. paulkomenda@yahoo.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Komenda
mesh_terms: D000328:Adult; D064752:Atrial Remodeling; D004452:Echocardiography; D005260:Female; D006437:Hemodialysis, Home; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012648:Self Care; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D020257:Ventricular Remodeling
keywords: Cardiac imaging; High dose hemodialysis; Home hemodialysis; Left ventricular hypertrophy