Hemodiafiltration and hemodialysis differently affect P wave duration and dispersion on the surface electrocardiogram.

Aim: The incidence of atrial fibrillation is increased during hemodialysis (HD); however, the effects of hemodiafiltration (HDF) on atrial arrhythmias have not been evaluated. The prolongation of the P wave and P dispersion (Pd) can predict atrial arrhythmias.

Methods: Data from 30 patients receiving HDF over a period of 3 months were collected; the same group of patients was then evaluated during treatment with conventional HD for at least another 3 months.

[End stage renal disease and ventricular arrhythmia. Hemodialysis and hemodiafiltration differently affect ventricular repolarization].

Various factors (hypertension [27%], diabetes mellitus [40%]) and their cardiovascular complications play an important role in the genesis of end stage renal disease. Furthermore, primary kidney diseases (glomerulonephritis, tubulointerstitial nephritis, obstructive uropathy, analgesic nephropathy, polycystic kidney disease, autoimmune diseases) have an unfavorable effect on the cardiovascular outcome of this particular population. Increased susceptibility for arrhythmias may be caused by intermittent volume overload, metabolic disturbance, renal anemia, structural and electrophysiological changes of the myocardium, inflammatory mechanisms that may worsen the mortality statistics of these patients.

Pseudopheochromocytoma induced by anxiolytic withdrawal.

Background: Symptomatic paroxysmal hypertension without significantly elevated catecholamine concentrations and with no evidence of an underlying adrenal tumor is known as pseudopheochromocytoma.

Methods: We describe the case of a female patient with paroxysmal hypertensive crises accompanied by headache, vertigo, tachycardia, nausea and altered mental status. Previously, she was treated for a longer period with alprazolam due to panic disorder.

Pathophysiological and clinical approach to cirrhotic cardiomyopathy.

Hyperdynamic circulation, systolic and diastolic left ventricular dysfunction and certain electrophysiological abnormalities have been associated with cirrhosis and known for a long time. These clinical features have been introduced as cirrhotic cardiomyopathy (CCM), which is characterized by blunted myocardial contractile responsiveness to physical, physiological and pharmacological stress. Importantly, cardiac dysfunction can be reversible and can improve due to effective medical treatment and also after liver transplantation.

Hemodiafiltration beneficially affects QT interval duration and dispersion compared to hemodialysis.

Background/aims: The prolongation of the QT interval and dispersion could predict ventricular arrhythmias. It is not yet established whether there is a difference between the effects of hemodialysis and hemodiafiltration on QT interval duration and dispersion.

Methods: Data of thirty patients was investigated while they were receiving hemodiafiltration over a period of 3 months; then the same group of patients was evaluated during treatment with conventional hemodialysis for at least another 3 months.

Hemodialysis and hemodiafiltration differently modulate left ventricular diastolic function.

Background: Renal replacement therapy may have a favorable effect on diastolic left ventricular function, but it is not clear whether hemodiafiltration is superior to hemodialysis in this field. Nitric oxide (NO) and asymmetric dimethylarginine (ADMA) may play a role in the changes of intracardiac hemodynamics, but it is not clear whether the different renal replacement methods have disparate influence on the metabolism of these materials.

Methods: Thirty patients on renal replacement therapy were investigated.