Journal Article

Left ventricular growth after 1 year of haemodialysis does not correlate with arteriovenous access flow: a prospective cohort study

Swapnil Hiremath, Steve P. Doucette, Robert Richardson, Kwan Chan, Kevin Burns and Deborah Zimmerman

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 8, pages 2656-2661
Published in print August 2010 | ISSN: 0931-0509
Published online February 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq081
Left ventricular growth after 1 year of haemodialysis does not correlate with arteriovenous access flow: a prospective cohort study

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Background. The incidence of congestive heart failure is 3-fold greater than that of acute coronary syndrome in haemodialysis (HD) patients. The purpose of this study was to determine if blood flow through an arteriovenous (AV) access contributes to an increase in left ventricular mass (LVM) that may increase the risk of congestive heart failure.

Methods. We conducted a 1-year prospective cohort study at two Canadian centres of HD patients at high risk for congestive heart failure who had a first AV access created. Patients underwent echocardiography and measurement of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels before and 1-year post-AV access creation. Access flows were measured within the first month of access maturation and 1-year post-access creation. Data were analysed using descriptive statistics, Student's t-test, correlation coefficients and regression.

Results. One-year post-AV access creation, LVM increased by 12.2 ± 32% (P = 0.025) and plasma NT-proBNP levels increased by 170 ± 465% (P = 0.02). The average AV access blood flow did not correlate with an increase in LVM or NT-proBNP levels.

Conclusions. In patients on chronic HD after 1 year, AV access flow does not correlate with increases in LVM by echocardiography or plasma levels of NT-proBNP.

Keywords: arteriovenous access; haemodialysis; left ventricular mass; NT-proBNP

Journal Article.  3761 words.  Illustrated.

Subjects: Nephrology

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