ID 53742
タイトル(別表記)
Non-high-output cardiac failure in patients undergoing hemodialysis through an arteriovenous shunt
フルテキストURL
Thumnail 127_203.pdf 686 KB
著者
鵜川 豊世武 岡山大学大学院医歯薬学総合研究科
抄録
Background: Hemodialysis-related heart failure has been considered to be associated with excessive blood flow through the arteriovenous (AV) shunt used for vascular access. However, some patients undergoing dialysis have heart failure in the absence of an increase in cardiac output (CO) related to shunt blood-flow loading because the loading cannot be compensated for by increasing CO. This condition may be challenging to manage ; thus, early diagnosis is important. Methods and Results: Twelve patients (mean age, 71 years ; 9 men) with end-stage renal disease, dialysis-related heart failure, a high brain natriuretic peptide (BNP) level, and a mean New York Heart Association (NYHA) class of II underwent AV shunt closure. Their cardiac index (CI), pre- and post-dialysis BNP levels, and several cardiac variables were assessed pre- and postoperatively. All patients achieved relief of heart failure symptoms and a reduction in NYHA class after AV closure, but six patients had a postoperative increase in CI (the "non-high-output" cardiac failure group), whereas the other six had a decrease in CI (the "high-output" cardiac failure group). The high-output patients had greater improvements in BNP levels and most cardiac variables compared to the non-high-output group ; therefore, the heart failure in the non-high-output patients was considered more serious than that in the high-output group. Conclusions: The selection of effective strategies for treating dialysis-related heart failure may depend partly on identifying which patients have non-high-output failure. Such identification requires serial measurements of BNP levels and evaluations of cardiac variables other than the ejection fraction.
キーワード
心拍出量(cardiac output)
心不全(heart failure)
脳性ナトリウム利尿ペプチド(brain natriuretic peptide)
非過大シャント心不全(non-high-output cardiac failure)
腎臓(kidney)
備考
原著 (Original Paper)
出版物タイトル
岡山医学会雑誌
発行日
2015-12-01
127巻
3号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
203
終了ページ
207
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
関連URL
isVersionOf https://doi.org/10.4044/joma.127.203
OAI-PMH Set
岡山大学
言語
Japanese
著作権者
Copyright (c) 2015 岡山医学会
論文のバージョン
publisher
査読
有り
DOI
NAID
Sort Key
6
Eprints Journal Name
joma
参考文献
1)Ohira S, Naito H, Amano I, Azuma N, Ikeda K, Kukita K, Goto Y, Sakai S, Shinzato T, Sugimoto T, Takemoto Y, Haruguchi H, et al. ; Japanese Society for Dialysis Therapy : 2005 Japanese Society for Dialysis Therapy guidelines for vascular access construction and repair for chronic hemodialysis. Ther Apher Dial (2006) 10, 449-462.
2)III. NKF-K/DOQI clinical practice guidelines for vascular access : update 2000. Am J Kidney Dis (2001) 37, S137-181.
3)Stern AB, Klemmer PJ : High-output heart failure secondary to arteriovenous fistula. Hemodial Int (2011) 15, 104-107.
4)Chemla ES, Morsy M, Anderson L, Whitemore A : Inflow reduction by distalization of anastomosis treats efficiently high-inflow high-cardiac output vascular access for hemodialysis. Semin Dial (2007) 20, 68-72.
5)Ugawa T, Sakurama K, Kanashima N, Tsuji A, Nikaidou M, Kojyou M, Ichiba S : A case of a hemodialysis patient with heart failure who received a vascular access route change operation by brachial artery jumping bypass grafting (BAJBG) and closure of previous arteriovenous fistula, that gained improved heart function. Ther Eng (2009) 21, 192-195 (In Japanese).
6)Ugawa T, Sakurama K, Tsuji A, Nikaidou Y, Azuma D, Kino K, Hirayama T, Shiba N, Ichiba S, Ujike Y : 2 years accumulated patency of shunt-less vascular access (brachial artery jumping bypass grafting : BAJBG) for heart failure patients with end-stage renal disease. Kidney Dial (2010) 69, 703-707 (In Japanese).
7)鵜川豊世武 : 動脈ジャンピンググラフトーシャントレスバスキュラーアクセスである上腕動脈ジャンピングバイパスグラフト術 (Brachial-Artery Jumping Bypass Grafting ; BAJBG) の5年累積開存率 : バスキュラーアクセス治療学, 春口洋昭編, 中外医学社, 東京 (2013) pp68-76.
8)Palazzuoli A, Quatrini I, Calabrò A, Antonelli G, Caputo M, Campagna MS, Franci B, Nuti R : Anemia correction by erythropoietin reduces BNP levels, hospitalization rate, and NYHA class in patients with cardio-renal anemia syndrome. Clin Exp Med (2011) 11, 43-48.
9)Bednarek-Skublewska A, Zaluska W, Ksiazek A : The relationship between serum level of N-terminal pro-B-type natriuretic peptide and nutritional status, and inflammation in chronic hemodialysis patients. Clin Nephrol (2010) 73, 14-20.
10)Zuber M, Kipfer P, Attenhofer Jost CH : Usefulness of acoustic cardiography to resolve ambiguous values of B-type natriuretic peptide levels in patients with suspected heart failure. Am J Cardiol (2007) 100, 866-869.
11)Zuber M, Kipfer P, Attenhofer Jost CH : Systolic dysfunction :
correlation of acoustic cardiography with Doppler echocardiography. Congest Heart Fail (2006) 12, S14-18.
12)Koch M, Trapp R, Kohnle M, Aker S, Haastert B, Rump LC : B-type natriuretic peptide and severe heart failure at baseline predict overall mortality in incident dialysis patients. Clin Nephrol (2010) 73, 21-29.
13)Ishii J, Nomura M, Okuma T, Minagawa T, Naruse H, Mori Y, Ishikawa T, Kurokawa H, Hirano T, Kondo T, Nagamura Y, Ezaki K, et al. : Risk stratification using serum concentrations of cardiac troponin T in patients with end-stage renal disease on chronic maintenance dialysis. Clin Chim Acta (2001) 312, 69-79.
14)Ishii J, Nomura M, Nakamura Y, Naruse H, Mori Y, Ishikawa T, Ando T, Kurokawa H, Kondo T, Nagamura Y, Ezaki K, Hishida H : Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure. Am J Cardiol (2002) 89, 691-695.
15)久野貴弘, 石井潤一, 岩島重二郎, 青山 徹, 春日弘毅 : 透析患者の予後評価におけるトロポニンTとBNP濃度組合せの有用性. 藤田学園医会誌 (2006) 30, 145-148.
16)CKD Guideline Editorial Committee : Evidence-based practice guideline for the treatment of CKD. Nippon Jinzo Gakkai Shi (2009) 51, 905-1066 (In Japanese).
17)Glassock RJ, Winearls C : Diagnosing chronic kidney disease. Curr Opin Nephrol Hypertens (2010) 19, 123-128.
18)Sakuma M, Nakamura M, Tanaka F, Onoda T, Itai K, Tanno K, Ohsawa M, Sakata K, Yoshida Y, Kawamura K, Makita S, Okayama A : Plasma B-type natriuretic peptide level and cardiovascular events in chronic kidney disease in a community-based population. Circ J (2010) 74, 792-797.
19)Joki N, Hase H, Ishikawa H, Fukazawa C, Nakamura R, Imamura Y, Tanaka Y, Saijyo T, Fukazawa M, Yamaguchi T : Coronary artery disease as a definitive risk factor of short-term outcome after starting hemodialysis in diabetic renal failure patients. Clin Nephrol (2001) 55, 109-114.
20)山本一博 : 拡張不全の現時点での考え方とその診断. 治療 (2007) 89, 2024-2032.
21)半田俊之介 : 拡張不全の病態と治療. 診断と治療 (2005) 93, 49-55.
22)渡辺 淳 : 拡張不全の治療 : 期待される治療戦略. 心臓 (2005) 37, 212-216.
23)2009年度合同研究班 : 慢性心不全治療ガイドライン (2010年改訂版).
24)Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, et al. ; American College of Cardiology ; American Heart Association Task Force on Practice Guidelines ; American College of Chest Physicians ; International Society for Heart and Lung Transplantation ; Heart Rhythm Society : ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult : a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) : developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation : endorsed by the Heart Rhythm Society. Circulation (2005) 112, e154-235.
25)福井次矢, 黒川 清監修 : ハリソン内科学 第2版, ティンズリ・ランドルフ・ハリソン著, MEDSi, 東京 (2006).
過去1年のアクセス数
アクセス数 : ?
ダウンロード数 : ?

今月のアクセス数
アクセス数 : ?
ダウンロード数 : ?