Probing dry-weight improves left ventricular mass index.

BACKGROUND

Although probing dry-weight improves blood pressure control, its effect on echocardiographic left ventricular mass index (LVMI) is unknown.

METHODS

Shortly following dialysis, 292 echocardiograms in 150 patients participating in the DRIP trial were obtained at baseline and longitudinally every 4 weeks on 2 occasions.

RESULTS

At baseline, LVMI was 136.3 g/m(2) in the control group and 138.7 g/m(2) in the ultrafiltration group (p > 0.2 for difference). The change from baseline in LVMI in the control group was +3.5 g/m(2) at 4 weeks and +0.3 g/m(2) at 8 weeks (p > 0.2 for both changes). The change from baseline in LVMI in the ultrafiltration group was -7.4 g/m(2) at 4 weeks (p = 0.005) and -6.3 g/m(2) at 8 weeks (p = 0.045). With ultrafiltration, the change in LVMI diameter was -10.9 g/m(2) more compared to the control group at 4 weeks (p = 0.012) and -6.6 g/m(2) more compared to the control group at 8 weeks (p = 0.21). The reduction in interdialytic ambulatory blood pressure was also greater in response to probing dry-weight in those in the top half of LVMI at baseline (p = 0.02 for interaction effect at week 8).

CONCLUSION

LVMI, an important determinant of prognosis among long-term dialysis patients, is responsive to probing dry-weight.