Estudo da morfologia e função cardíacas nos pacientes em hemodiálise com e sem diurese residual

Abstract

Background: In patients with chronic renal disease (CRD) on hemodialysis (HD), left ventricular hypertrophy (LVH) is related to the increase in total peripheral vascular resistance (TPVR) and volume overload. The presence of residual diuresis (RD) enables greater control of these patients blood volume. Methodos: We evaluated the morpho-functional changes of the left ventricle (LV) in patients with CRD on HD with and without residual diuresis. Results: A total of 31 patients were divided into two groups using data from a Doppler echocardiogram: those with residual diuresis (G1) (n=17) and those without residual diuresis (G2) (n=14). In both groups, G1 vs. G2, differences in the cardiac index occurred (3.9 ± 0.20 vs. 3.0 ± 0.21 l/min/m2; p = 0.0056), systolic index (54 ± 2.9 vs. 45 ± 3.3 ml/b/m2; p = 0.04), end diastolic volume (141 ± 6.7 vs. 112 ± 7.6 ml; p = 0.008), end diastolic diameter (52 ± 0.79 vs. 48 ± 1.12 mm; p = 0.0072) and TPVR (1121 ± 56 vs. 1529 ± 111 dyne.seg.cm-5; p = 0.001 ). G1 had lower relative wall thickness than G2 (0.38 ± 0.01 vs. 0.45 ± 0.01; p = 0.0008). The ejection fraction (66.00 ± 1.24 vs. 66.0 ± 1.46%; p = 0.873) and the left ventricular mass index (132 ± 6.0 vs. 130 ± 8.3 g/m; p = 0.798) were similar in both groups. The urinary 24-hour volume correlated with relative wall thickness (r = -0.42; p = 0.0186) and with TPVR (r = -0.48; p = 0.0059). Conclusion: Distinct ventricular geometric patterns existed and were determined using the different RWT and TPVR in the groups with and without residual dieresis.