Chronic Kidney Disease Stage 5, Heart Failure
Conditions
Brief summary
Heart failure with preserved / high cardiac output is a well-known syndrome in patients with high-flow arteriovenous fistula (AVF). However, the threshold for classifying an AVF as high-flow is currently undefined. Cardio-fistular recirculation (CFR) is often used as a criterion, with values greater than 25-30% considered cardiotoxic and associated with adverse outcomes. Additionally, CFR is one of the few easily modifiable risk factors through surgical reduction of AVF volume blood flow (Qa). The study aimed to evaluate the extent of involution of heart structural and functional changes following Qa reduction in patients with heart failure and CFR \> 25%.
Interventions
None listed
Sponsors
Moscow Regional Research and Clinical Institute (MONIKI)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Signed informed consent * age \> 18 years * CKD 5D * Native arteriovenous fistula or vascular graft * Heart failure with preserved CO (NYHA I-IV ) * Cardio-fistula recirculation ≥ 25% * eKt/V \> 1.2 * Absence of arrhythmias (except grade I AV block) * Absence of valvular disease (except mitral regurgitation I-II) * Arteriovenous fistula blood flow reduction surgery
Exclusion criteria
* Death * Kidney transplantation * Conversion of vascular access to central venous catheter * Withdrawal of informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Left ventricular ejection fraction | Before and at 6 months after surgery |
| Estimated pulmonary artery pressure | Before and at 6 months after surgery |
| E/A ratio | Before and at 6 months after surgery |
Secondary
| Measure | Time frame |
|---|---|
| NT-proBNP serum concentration | Before and at 6 months after surgery |
Countries
Russia
Outcome results
None listed