The effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal-cardiac syndrome / 中国医师进修杂志

ABSTRACT

Objective:To explore the effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal heart syndrome(CRCS).Methods:Sixty elderly patients with CRCS who were admitted to Qinhuangdao Port Hospital from July 2017 to July 2018 were selected and divided into the observation group (received hemodialysis and conventional treatment) and the control group (received conventional treatment) according to the random number table method, each group with 30 patients. The levels of left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and left atrium anterior and posterior diameter (LAD) before and after treatment of two weeks were compared between two groups, the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), cystatin C (CysC), creatinine (Cr) and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein (hs-CPR), interleukin 6 (IL-6) before and after treatment for two week were compared between two groups, and the safety of the two treatment methods was evaluated.Results:After treatment, the levels of LVESD, LVEDD, LAD in the observation group were lower than those in the control group (26.13 ± 1.28) mm vs. (29.09 ± 1.26) mm, (47.58 ± 1.22) mm vs. (51.34 ± 1.49) mm, (30.02 ± 0.83) mm vs. (33.15 ± 1.02) mm, the level of LVEF in the observation group was higher than that in the control group (39.63 ± 5.21)% vs. (35.77 ± 4.93)%, the differences were statistically significant ( P<0.05). After treatment, the levels of NT-proBNP, BUN, CysC and Cr in the observation group were lower than those in the control group (1 089.31 ± 243.29) ng/L vs. (2 990.56 ± 531.22) ng/L, (16.08 ± 3.35) mmol/L vs.(21.93 ± 4.21) mmol/L, (0.35 ± 0.11) mg/L vs. (0.57 ± 0.18 mg/L, (251.62 ± 29.28) μmol/L vs. (290.66 ± 38.12) μmol/L, the differences were statistically significant ( P<0.05). After treatment, the levels of TNF-α, hs-CPR and IL-6 in the observation group were lower than those in the control group (149.26 ± 19.53) μg/L vs. (182.33 ± 20.25) μg/L, (4.02 ± 1.33) mg/L vs. (5.38 ± 1.57) mg/L, (18.91 ± 3.11) μg/L vs. (22.45 ± 3.82) μg/L, the differences were statistically significant ( P<0.05). The incidence of adverse reactions during the treatment in the two groups had no significant difference ( P>0.05). Conclusions:The use of hemodialysis on the basis of conventional treatment can improve the heart and kidney function of elderly patients with CRCS, and this method is beneficial to alleviate left heart dilation and inflammation. It is a safe and effective treatment method.