Relationship of Vascular Access Flow with Impaired Right Ventricular Function in Chronic Hemodialysis Patients


Background: Cardiovascular events are the leading cause of morbidity and mortality in chronic hemodialysis patients. Impaired right ventricular function is often associated with poor survival in hemodialysis patients. Objective: To determine the effect of vascular access flow (AVFs) of right ventricular function. Methods: This cross-sectional study was done in Department of Nephrology, DMCH during the period January 2020 to July 2021. End stage renal disease patient underwent hemodialysis for ≥3 months were recruited in the study. Patients with chronic respiratory disease, severe valvar heart disease, AVFs flow<200ml/min were excluded. Right ventricular function was assessed by Tricuspid Annular Plane Systolic Excursion (TAPSE) through echocardiography and AVFs blood flow by color duplex study. History for diabetes mellitus, glomerulonephritis and hypertension were retrieved from medical records in addition to variable age and gender. Results of the biochemical variable also retrieved. TAPSE ≤16mm was taken as cut off to characterize subjects as Group I, impaired right ventricular function. Those with >16mm termed as Group II, normal right ventricular function. Data were expressed as mean±SD and number (present) as appropriate. Unpaired student t test, invariable and multivariable analysis were performed as applicable using statistical package for social science (SPSS). p<0.05% was taken as level of significant. Results: Of the total 80 subject 26 constituted Group I and 54 in Group II. Distribution of male and female did not show any statistical association. Distribution of gender in two groups did not show any statistical association. Distribution of the subjects in age cluster was similar in the two groups.

History of DM, GN, and HTN distribution in the two groups was also similar. Duration of hemodialysis (mean±SD) in Group I was 28.04 months and 26.39 months in Group II; two group did not show statistical difference (p=0.529). Systolic blood pressure was 163 mmHg and 160mmHg in Group I and Group II respectively and diastolic blood pressure (mean±SD, mmHg) was 92mmHg and 92mmHg in Group I and Group II respectively; did not statistical difference (p=0.283 and 0.960 respectively). AVFs blood flow 1603±382ml/min (mean±SD,ml/min) in group I was significantly higher compared to the counterpart group II 791±189ml/min. The trend was supported by the significant (p=0.001) inverse relationship between TAPSE and AVFs blood flow. In Group I radio cephalic and brachiocephalic AV fistula distribution was 12 vs 24 (46.2 vs 53.8%) which in the Group II was 51 vs 3(94.4 vs 5.6%). Conclusion: Data concluded that brachiocephalic AVFs lead to significantly higher blood flow than the radio cephalic fistula resulting impaired right ventricular function, which reconfirmed the usefulness of distal AVF as a vascular access in patient for hemodialysis.
 

https://www.stephypublishers.com/tunr/pdf/TUNR.MS.ID.000507.pdf

Comments

Post a Comment

Popular posts from this blog

Journal of Psychological Science and Research - (JPSSR) | Stephy Publishers

Image
  Journal of Psychological Science and Research - (JPSSR) | Stephy Publishers Journal of Psychological Science and Research is an international, peer reviewed open access journal, aims to publish articles on entire spectrum of the science of psychology. JPsSR acts as a source for the latest findings in social, developmental, cognitive, community, and health psychology, as well as behavioral neuroscience and biopsychology. The journal aims to publish high quality articles in the form of original research, review, case reports, mini-review, commentary, proceeding, editorial, etc. #Manuscriptsubmission https://www.stephypublishers.com/submit-manuscript.php More #Openaccessjournals https://www.stephypublishers.com/ # PsychologicalScience https://www.stephypublishers.com/psychological-science-and-research/
Read more
Image
 Resilience, Risk-Taking Behavior and Aggression among Female Volleyball Players – a Preliminary Study The aim of the current study is to investigate the level of risk-taking behavior, resilience and aggression in female volleyball players and the link between these psychological variables and coach’s performance ranking. A Romanian volleyball team ranked 7th out of 11 in the A1 league in the national championship (2022-2023 period) participated at the study. The Romanian adaptation of the Brief Resilience Scale, The Romanian adaptation of Makarowski’s Stimulating and Instrumental Risk Questionnaire, The Romanian adaptation of Makarowski's Aggression Questionnaire and Delphi method (evaluation of female volleyball players by coaches) were used. Analysis of the results reveals that athletes have a low level of perseverance (Go-Ahead factor), a low level of Foul play and a moderate to low level of assertiveness. Also, most athletes registered average or even low levels of resilience
Read more
Image
 Chemo stratigraphic Profile of a Reservoir in Well “X” of Field “Y” Offshore Southern Gabon - Stephy Publishers In a bid to evaluate the elemental and mineralogical content of reservoir samples from the “X” well in the “Y” oil field offshore Southern Gabon, analyses were performed using XRD and XRF. The log view profile of the result inferred that Na, Mg, and Calcite were absent in the shallower series of the reservoir sandstones studied, this observation implies that they are soluble ions that had eroded and refer to warm and humid paleoclimate and a depositional environment that is arid, which corresponds to the continental crust as their source. The plot of Ti and FeO+Mg discriminate the deeper series of the reservoir sandstone samples from the shallower samples. The lower series showed heavier values which implies their origin from Oceanic Crust. These are also the pre-salt facies while the shallower series were more of continental origin and represent the post-salt facies. https:
Read more