BACKGROUND: Although probing dry-weight improves blood pressure control, its effect on echocardiographic left ventricular mass index (LVMI) is unknown. METHODS: Shortly following dialysis, 292 echocardiograms in 150 patients participating in the DRIP trial were obtained at baseline and longitudinally every 4 weeks on 2 occasions. RESULTS: At baseline, LVMI was 136.3 g/m(2) in the control group and 138.7 g/m(2) in the ultrafiltration group (p > 0.2 for difference). The change from baseline in LVMI in the control group was +3.5 g/m(2) at 4 weeks and +0.3 g/m(2) at 8 weeks (p > 0.2 for both changes). The change from baseline in LVMI in the ultrafiltration group was -7.4 g/m(2) at 4 weeks (p = 0.005) and -6.3 g/m(2) at 8 weeks (p = 0.045). With ultrafiltration, the change in LVMI diameter was -10.9 g/m(2) more compared to the control group at 4 weeks (p = 0.012) and -6.6 g/m(2) more compared to the control group at 8 weeks (p = 0.21). The reduction in interdialytic ambulatory blood pressure was also greater in response to probing dry-weight in those in the top half of LVMI at baseline (p = 0.02 for interaction effect at week 8). CONCLUSION:LVMI, an important determinant of prognosis among long-term dialysis patients, is responsive to probing dry-weight.
RCT Entities:
BACKGROUND: Although probing dry-weight improves blood pressure control, its effect on echocardiographic left ventricular mass index (LVMI) is unknown. METHODS: Shortly following dialysis, 292 echocardiograms in 150 patients participating in the DRIP trial were obtained at baseline and longitudinally every 4 weeks on 2 occasions. RESULTS: At baseline, LVMI was 136.3 g/m(2) in the control group and 138.7 g/m(2) in the ultrafiltration group (p > 0.2 for difference). The change from baseline in LVMI in the control group was +3.5 g/m(2) at 4 weeks and +0.3 g/m(2) at 8 weeks (p > 0.2 for both changes). The change from baseline in LVMI in the ultrafiltration group was -7.4 g/m(2) at 4 weeks (p = 0.005) and -6.3 g/m(2) at 8 weeks (p = 0.045). With ultrafiltration, the change in LVMI diameter was -10.9 g/m(2) more compared to the control group at 4 weeks (p = 0.012) and -6.6 g/m(2) more compared to the control group at 8 weeks (p = 0.21). The reduction in interdialytic ambulatory blood pressure was also greater in response to probing dry-weight in those in the top half of LVMI at baseline (p = 0.02 for interaction effect at week 8). CONCLUSION: LVMI, an important determinant of prognosis among long-term dialysis patients, is responsive to probing dry-weight.
Authors: Christopher T Chan; John S Floras; Judith A Miller; Robert M A Richardson; Andreas Pierratos Journal: Kidney Int Date: 2002-06 Impact factor: 10.612
Authors: Gérard M London; Bruno Pannier; Alain P Guerin; Jacques Blacher; Sylvain J Marchais; Bernadette Darne; Fabien Metivier; Hassan Adda; Michel E Safar Journal: J Am Soc Nephrol Date: 2001-12 Impact factor: 10.121
Authors: Simon D Roger; Lawrence P McMahon; Anthony Clarkson; Alex Disney; David Harris; Carmel Hawley; Helen Healy; Peter Kerr; Kelvin Lynn; Alan Parnham; Roess Pascoe; David Voss; Robert Walker; Adeera Levin Journal: J Am Soc Nephrol Date: 2004-01 Impact factor: 10.121