Myocardial Perfusion Found to Decline with Hemodialysis

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Nephrol Dial Transplant. 2009;24:604-610

Hemodialysis (HD) is associated with a pronounced drop in myocardial perfusion, a study shows.

Investigators from the Netherlands and the United Kingdom used positron emission tomography (PET) to quantify changes in myocardial blood flow (MBF), left ventricular (LV) wall motion, cardiac output (CO), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) in seven nondiabetic HD patients. PET scans were performed before and at 30 and 220 minutes of HD.

Mean global MBF decreased during HD in all patients. After 30 minutes of HD without ultrafiltration (UF), global MBF decreased by a mean 13.5% compared with baseline, and CO, LVEDV, and LVESV decreased by 4.6%, 5.6%, and 6.9%, respectively.

All of the decreases were significant except the CO decline. At 220 minutes of HD, after UF of 2.5 L, global MBF declined by 26.6% from baseline and CO, LVEDV, and LVESV decreased by 21%, 31%, and 13%, respectively. All changes were significant.

The authors concluded that HD-associated reductions in MBF “may contribute to the high cardiac event rate of dialysis patients.”

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