Frequency of painless myocardial ischemia during hemodialysis in 50 patients with chronic kidney failure
Pochmalicki, G.; Jan, F.; Fouchard, I.; Teiger, E.; Buisson, C.; Benmaadi, A.; Boesch, C.; Rostoker, G.
Archives des Maladies du Coeur et des Vaisseaux 83(11): 1671-1675
1990
ISSN/ISBN: 0003-9683 PMID: 2122844 Document Number: 365236
The authors carried out a prospective study to determine the frequency of silent ischemia (SI) in 50 consecutive patients with end stage renal failure during dialysis by Holter monitoring. Twenty patients had SI (40%). This event was related to the number of cardiovascular risk factors (p = 0.0025), principally diabetes, smoking and the underlying renal disease (p = 0.018), and to a history of coronary artery disease (p = 0.0015). Two patients died during the nine months follow-up period and both had SI on Holter monitoring. Dialysis therapy in anaemic patients may predispose to and facilitate the detection of myocardial ischemia by the simultaneous interplay of hypotension, hypovolemia, hypoxia and tachycardia. The detection of these ischemic events may allow identification of a subgroup of dialysis patients with a high cardiovascular risk. The prognosis of these patients and best therapeutic approach require further study.