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There is a hypothesis that a subgroup of patients with reversal of
systolic dysfunction following hemodialysis have fluid overload.
However, the underlying pathology has not been understood in those
patients without significant fluid overload. Inflammatory markers
have been found to be raised in chronic kidney disease, which
prompts the theory for an underlying inflammatory pathology as a
cause of reversible cardiac dysfunction in this group of patients.
We studied 52 patients with chronic kidney disease. There were 29
patients with systolic dysfunction. Twenty three patients with
preserved systolic function, had diastolic dysfunction. Of the 29
patients with systolic dysfunction, 10 patients had significant
improvement in NYHA functional class, left ventricular dimensions,
left ventricular ejection fraction . None of the patients had
significant changes in dry weight. These patients had the highest
baseline serum levels of troponin I which decreased significantly
with recovery of cardiac function along with the c reactive protein
levels. Those patients with C reactive protein greater than median
change had significant improvements in LVIDs and EF.
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