Correlation between right ventricular function and intradialytic hypotension in patients with chronic renal failure on regular hemodialysis

Document Type : Original Article

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Cardiology department, Al-Azhar university Faculty of medicine, Cairo.

https://doi.org/10.21608/aimj.2025.446571

Abstract

Background: The right side of the heart plays a role in maintaining pulmonary circulation and systemic hemodynamic stability. Intradialytic-hypotension (IDH) is a hemodialysis frequent complication, leading to increased morbidity-mortality. It results from impaired compensatory mechanisms, including cardiac dysfunction. This study evaluates right ventricular (RV) function in hemodialysis-patients with and without IDH using transthoracic echocardiography (TTE) and strain imaging.
Methods: A cross-sectional study was conducted on 50 chronic kidney disease (CKD) patients undergoing regular hemodialysis at Al-Azhar University Hospitals. Patients divided into-two groups: 35 with IDH and 15 without. Echocardiographic parameters, including LV ejection-fraction (LVEF), global-longitudinal-strain (GLS), RV fractional-area-change (FAC), and tricuspid-annular-plane-systolic-excursion (TAPSE), were assessed.
Results: IDH patients had significantly impaired RV function, with lower TAPSE (18.5 ± 1.12 mm vs. 21.5 ± 2.8 mm, p < 0.001), reduced RV FAC (36.1 ± 3.08% vs. 42.3 ± 2.35%, p < 0.001), and impaired RV GLS (-19.8 ± 1.53% vs. -23.5 ± 2.2%, p < 0.001). LV function was also compromised, with lower LVEF (55.2 ± 2.7% vs. 57.9 ± 1.83%, p < 0.001) and increased LV volumes.
Conclusion: IDH is associated with significant RV dysfunction. RV GLS and TAPSE emerged as key predictors, highlighting the need for advanced echocardiographic assessments to improve risk stratification and management in hemodialysis patients.
 

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