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Year : 2016  |  Volume : 26  |  Issue : 5  |  Page : 352--356

High hemodialysis vascular access flow and impaired right ventricular function in chronic hemodialysis patients

S Yilmaz1, M Yetim2, BK Yilmaz3, T Dogan2, E Aksoy1, N Yuksel4, I Dogan5 
1 Department of Cardiovascular Surgery, Hitit University Faculty of Medicine, Corum Education and Research Hospital, Corum, Turkey
2 Department of Cardiology, Hitit University Faculty of Medicine, Corum Education and Research Hospital, Corum, Turkey
3 Department of Radiology, Hitit University Faculty of Medicine, Corum Education and Research Hospital, Corum, Turkey
4 Department of Nursing, Hitit University Faculty of Medicine, Corum Education and Research Hospital, Corum, Turkey
5 Department of Nephrology, Hitit University Faculty of Medicine, Corum Education and Research Hospital, Corum, Turkey

Correspondence Address:
S Yilmaz
Dr. Ilhan Gürel Street, No. 9/4, Corum
Turkey

There are limited data showing right ventricular preload increase due to high-flow arteriovenous fistulas (AVFs). This cross-sectional study investigated whether high AVF flow had an impact on right ventricular function in patients undergoing hemodialysis. Sixty-four patients aged between 18 and 85 years who were on routine hemodialysis with >2 hemodialysis sessions per week for at least 3 months via an AVF were studied. Patients with inadequate flow fistulas, severe chronic obstructive pulmonary disease, history of pulmonary embolism, primary pulmonary hypertension, severe mitral, aortic or pulmonary regurgitation, and/or stenosis were excluded. After an initial evaluation, 44 patients (mean age: 58.50 ± 16.84, male:female = 23:21) were considered eligible. Right ventricular function was assessed by tricuspid annular plane systolic excursion (TAPSE). AVF blood flow was measured with duplex ultrasound. There were 15 patients (34.1%) with a TAPSE of <16 mm. AVF blood flow was significantly higher in patients with impaired versus normal right ventricular function (1631.53 ± 738.17 vs. 1060.55 ± 539.92 min/ml, respectively, P = 0.003). Low left ventricular ejection fraction (odds ratio [OR]: 1.15, 95% confidence intervals [CI]: 1.007-1.334, P = 0.04), high interventricular septum thickness (OR: 1.64, 95% CI: 1.104-2.464, P = 0.01), and high AVF blood flow (OR: 1.00, 95% CI: 1.000-1.003, P = 0.03) were independent predictors of impaired right ventricular function. In addition to known risk factors that predominantly increase right ventricular afterload, excessive AVF blood flow was found to be independently associated with impaired right ventricular function, possibly by increasing right ventricular preload.

How to cite this article:
Yilmaz S, Yetim M, Yilmaz B K, Dogan T, Aksoy E, Yuksel N, Dogan I. High hemodialysis vascular access flow and impaired right ventricular function in chronic hemodialysis patients.Indian J Nephrol 2016;26:352-356

How to cite this URL:
Yilmaz S, Yetim M, Yilmaz B K, Dogan T, Aksoy E, Yuksel N, Dogan I. High hemodialysis vascular access flow and impaired right ventricular function in chronic hemodialysis patients. Indian J Nephrol [serial online] 2016 [cited 2022 Jan 22 ];26:352-356
Available from: https://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2016;volume=26;issue=5;spage=352;epage=356;aulast=Yilmaz;type=0