Echocardiography Parameters During Long And Short Interdialytic Intervals In Hemodialysis Patients

Background: In patients receiving haemodialysis (HD) cardiovascular disease  is the leading cause of mortality. Most HD patients follow the typical schedule of three sessions per week, and thus remain outside dialysis for (~ 2 days in duration) short intervals and for a longer interval (~3 days) at the end of each week. Objective: Comparison between echocardiographic parameters during the 2- day (short) and 3-day (long) interdialytic intervals in prevalent HD patients.Patients and Methods: The study involved 30 stable prevalent HD patients on thrice weekly regimen. Echocardiography was done before and after the short and long interdialytic interval to study left and right ventricle functions and inferior vena cava (IVC) diameter. Patients’ mean age was 56.23 ± 12.31 years (43.4% females and 56.7% males).  Results: Comparison of echocardiographic measurements was done before and after dialysis between the short (2-days) and long (3-day) interdialytic interval groups (Group 1 Vs Group 2) we found that there were statistically highly significant differences among left pulmonary capillary wedge pressure (PCWP), IVC diameter and interdialytic weight change after dialysis session between the short and the long interdialytic interval patients' groups. The intradialytic weight gain (2.45 ± 1.13 vs 1.19 ± 0.78   kg), IVC diameter (11 ± 2.98 vs 9.62 ± 2.32) and PCWP (11.13 ± 2.3 vs 10.13 ± 1.55) increases were higher during the 3-day versus the 2-day interval (P < 0.001 ). There were no statistically significant differences between left ventricular (LV) systolic and diastolic dimensions, septum affection, ejection fraction, or pulmonary artery pressure. Conclusion: IVC, PCWP and intradialytic weight increase was higher during the 3-day versus the 2-day interval in post dialysis comparison. IVC, PCWP and intradialytic weight gain reflect degree of volume overload and their increase especially after interdialytic interval call for need to evaluate timing and frequency of prescribed HD regimens for some HD patients.