| Theme |
Cardiovascular Complications in Chronic Dialysis Patients -- Are They Inevitable? |
| Title |
Heart failure and uremic cardiomyopathy |
| Author |
Tadashi Tamura |
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine |
| [ Summary ] |
Uremic cardiomyopathy is a syndrome characterized by left ventricular systolic dysfunction and dilatation, or left ventricular hypertrophy, such as that seen in idiopathic cardiomyopathy. In dialysis patients, periodic echocardiography is useful for the early diagnosis of uremic cardiomyopathy and assessment of overhydrated states. Diagnosis is performed by exclusion of excessive abnormalities related to a single uremic factor or coronary artery disease. The adjustment of several uremic factors and reduction of body weight may improve cardiac function in dialysis patients with dilated uremic cardiomyopathy. Some medications may be associated with improvements in left ventricular function, although we do not have much evidence of these effects in dialysis patients. Diastolic dysfunction is most important cause of heart failure. Therefore, we need to understand its mechanism and carefully reduce body weight. |