Probing dry-weight improves left ventricular mass index

Am J Nephrol. 2011;33(4):373-80. doi: 10.1159/000326235. Epub 2010 Dec 13.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory / methods
  • Body Mass Index
  • Echocardiography / methods
  • Female
  • Heart Ventricles / pathology*
  • Humans
  • Hypertension / therapy*
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Kidney Failure, Chronic / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Renal Dialysis