Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 34

The prospective study cohort consisted of 30 hemodialysis (HD) and 32 peritoneal dialysis (PD) patients treated at Juntendo University Hospital from April 2002 to April 2008. Enrollment criteria included no history of congestive heart failure (defined as dyspnea or interstitial edema on chest X-ray), valvular disease, LV systolic dysfunction with an ejection fraction <50%, arrhythmia, or abnormal electrocardiograph. Diabetic patients were excluded from this study. All patients had arteriovenous fistulas created before initiation of HD and before enrollment into the study. All patients were treated with angiotensin type 1 receptor blocker to maintain blood pressure (BP) at <140/90 mm Hg. Other antihypertensive drugs, such as diuretics and/or calcium channel blockers, were added if BP increased >140/90 mm Hg. Other basic markers of volume status, such as clinical features of volume overload (edema and other signs and symptoms of heart failure), were also examined. Body fluid balance was controlled by measuring plasma atrial natriuretic peptide (ANP; normal range, <43.0 pg/mL [6]) and LA diameter (LAD; normal range, <39 mm [5]). Echocardiography was performed before or at the start of dialysis (baseline) and at 12 and 24 months. The protocol conformed to the ethical guidelines of our institutions, and informed consent was obtained from all participants.