| Theme | Heart and it's Diseases in Dialysis Patients -- For their better longevity | |
|---|---|---|
| Title | Uremic cardiomyopathy | |
| Publish Date | 2010/05 | |
| Author | Tokuichiro Sugimoto | Division of Nephrology, Department of Medicine, Mitsui Memorial Hospital |
| Author | Naobumi Mise | Division of Nephrology, Department of Medicine, Mitsui Memorial Hospital |
| Author | Noriaki Kurita | Division of Nephrology, Department of Medicine, Mitsui Memorial Hospital |
| [ Summary ] | Cardiomyopathy in dialysis patients is different from idiopathic cardiomyopathy in that there are many causes which affect the myocardium in relation to uremic pathology and dialysis for daily living. High blood pressure, repetitive fluid overload, coronary heart disease, and hypotension during hemodialysis are very common factors encountered. Left ventricular dilatation and impaired systolic function occur during various occasions during the course of long term dialysis. In order to maintain a good quality of life for dialysis patients with uremic cardiomyopathy, secondary preventative measures must be taken, including adequate dialysis prescriptions. Blood pressure control at home and during hemodialysis is important. Humoral factors such as control of calcium and phosphate, LDL cholesterol and triglyceride levels may be managed through diet and medication. When stable hemodynamic states are difficult to achieve, modification of dialysis modalities, including intervention for AV access blood flow should be considered. Physical exercise before and after initation of dialysis and even after the occurrence of heart disease appears to be important. The heart does not operate by itself but in concert with adequate lung ventilation, acceptable levels of peripheral circulation and healthy muscle condition including enzyme activities. Daily physical exercise will help to achieve and maintain quality of life for dialysis patients. |
|