Comparison of echocardiographic parameters during long and short interdialytic intervals in haemodialysis patients

Abstract

Cardiovascular disease is the leading cause of mortality in patients receiving haemodialysis (HD). Most HD patients follow the typical schedule of three sessions per week, and thus remain outside dialysis for two short intervals (~ 2 days in duration) and for a longer interval (~3 days) at the end of each week. There is a link between the long interdialytic interval and worsened cardiovascular outcomes but few studies have examined the underlying mechanisms Objective: To compare changes in echocardiographic parameters during the 2- day (short) and 3-day (long) interdialytic intervals of prevalent HD patients. Patients and Methods: The study involved 30 stable prevalent HD patients on thrice weekly regimen. Echocardiography was done before and after the short and long interdialytic interval to study left and right ventricle functions and inferior vena cava (IVC) diameter. Patients ages ranged between 28 and 75 years with mean age of 56.23±12.31 years (43.4% females and 56.7% males) Results: Comparison of echocardiographic measurements was done before and after dialysis between the short (2-days) and long (3-day) interdialytic interval groups (Group 1 Vs Group 2). There were no statistically significant differences between left ventricular (LV) systolic and diastolic dimensions, septum affection, ejection fraction, or pulmonary artery pressure. There were statistically highly significant differences among left pulmonary capillary wedge pressure (PCWP), IVC diameter and interdialytic weight change after dialysis session between the short and the long interdialytic interval patients' groups. The intradialytic weight gain (2.45 ± 1.13 vs 1.19 ± 0.78 kg), IVC diameter (11 ± 2.98 vs 9.62 ± 2.32) and PCWP (11.13 ± 2.3 vs 10.13 ± 1.55) increase were higher during the 3-day versus the 2-day interval (P < 0.001 ). Conclusion: IVC, PCWP and intradialytic weight increase was higher during the 3-day versus the 2-day interval in post dialysis comparison. IVC, PCWP and intradialytic weight gain reflect degree of volume overload and their increase especially after interdialytic interval call for need to evaluate timing and frequency of prescribed HD regimens for some HD patients>