The haemodynamic and cardiovascular effects of dialysis
Patients on dialysis are subject to hugely elevated rates of cardiovascular mortality. This thesis describes research work focusing on the large scale haemodynamic changes that occur during dialysis and how they may negatively impact on the cardiovascular system. Our results show that the haemodynam...
| Main Author: | |
|---|---|
| Format: | Thesis (University of Nottingham only) |
| Language: | English |
| Published: |
2007
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/10311/ |
| _version_ | 1848791062200451072 |
|---|---|
| author | Selby, Nicholas Michael |
| author_facet | Selby, Nicholas Michael |
| author_sort | Selby, Nicholas Michael |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Patients on dialysis are subject to hugely elevated rates of cardiovascular mortality. This thesis describes research work focusing on the large scale haemodynamic changes that occur during dialysis and how they may negatively impact on the cardiovascular system. Our results show that the haemodynamic disturbances that occur during haemodialysis are of sufficient magnitude to cause left ventricular (LV) regional wall motion abnormalities, reflecting subclinical myocardial ischaemia (myocardial stunning). This is pertinent as in non-dialysis patients repeated episodes of myocardial stunning lead to chronic heart failure, and in dialysis patients the presence of LV dysfunction dramatically increases the risk of death. We also explore how the haemodynamic effects of dialysis and the genesis of LV regional wall motion abnormalities can be ameliorated by using various interventions comprising of biofeedback dialysis (Hemocontrol and Diacontrol), cooling the dialysate and acetate free paired haemodiafiltration (PHF). We also examine the haemodynamic and metabolic effects of peritoneal dialysis (both continuous ambulatory and automated peritoneal dialysis) and show that these are much greater than previously thought. We also investigate possible mechanisms underlying these changes, namely alterations in cardiac filling and systemic glucose absorption leading to hyperinsulinaemia, and go on to examine the differential effects of the commercially available peritoneal dialysis solutions. Finally, we examine whether regional LV function is affected by the haemodynamic changes of CAPD. |
| first_indexed | 2025-11-14T18:22:32Z |
| format | Thesis (University of Nottingham only) |
| id | nottingham-10311 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T18:22:32Z |
| publishDate | 2007 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-103112025-02-28T11:07:49Z https://eprints.nottingham.ac.uk/10311/ The haemodynamic and cardiovascular effects of dialysis Selby, Nicholas Michael Patients on dialysis are subject to hugely elevated rates of cardiovascular mortality. This thesis describes research work focusing on the large scale haemodynamic changes that occur during dialysis and how they may negatively impact on the cardiovascular system. Our results show that the haemodynamic disturbances that occur during haemodialysis are of sufficient magnitude to cause left ventricular (LV) regional wall motion abnormalities, reflecting subclinical myocardial ischaemia (myocardial stunning). This is pertinent as in non-dialysis patients repeated episodes of myocardial stunning lead to chronic heart failure, and in dialysis patients the presence of LV dysfunction dramatically increases the risk of death. We also explore how the haemodynamic effects of dialysis and the genesis of LV regional wall motion abnormalities can be ameliorated by using various interventions comprising of biofeedback dialysis (Hemocontrol and Diacontrol), cooling the dialysate and acetate free paired haemodiafiltration (PHF). We also examine the haemodynamic and metabolic effects of peritoneal dialysis (both continuous ambulatory and automated peritoneal dialysis) and show that these are much greater than previously thought. We also investigate possible mechanisms underlying these changes, namely alterations in cardiac filling and systemic glucose absorption leading to hyperinsulinaemia, and go on to examine the differential effects of the commercially available peritoneal dialysis solutions. Finally, we examine whether regional LV function is affected by the haemodynamic changes of CAPD. 2007 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/10311/1/Microsoft_Word_-_thesis_V4.2.pdf Selby, Nicholas Michael (2007) The haemodynamic and cardiovascular effects of dialysis. DM thesis, University of Nottingham. haemodialysis peritoneal dialysis blood pressure hypotension myocardial stunning |
| spellingShingle | haemodialysis peritoneal dialysis blood pressure hypotension myocardial stunning Selby, Nicholas Michael The haemodynamic and cardiovascular effects of dialysis |
| title | The haemodynamic and cardiovascular effects of dialysis |
| title_full | The haemodynamic and cardiovascular effects of dialysis |
| title_fullStr | The haemodynamic and cardiovascular effects of dialysis |
| title_full_unstemmed | The haemodynamic and cardiovascular effects of dialysis |
| title_short | The haemodynamic and cardiovascular effects of dialysis |
| title_sort | haemodynamic and cardiovascular effects of dialysis |
| topic | haemodialysis peritoneal dialysis blood pressure hypotension myocardial stunning |
| url | https://eprints.nottingham.ac.uk/10311/ |