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Abstract: FR-PO555

Use of CardioMEMS in Dialysis Patients with Heart Failure

Session Information

Category: Trainee Case Report

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Viquez, Karolina, University of Kentucky, Lexington, Kentucky, United States
  • Mohamed, Amr El-Husseini, University of Kentucky, Lexington, Kentucky, United States
  • Elyamny, Mohamed, University of Kentucky, Lexington, Kentucky, United States
  • Fahmy, Karim, University of Kentucky, Lexington, Kentucky, United States
  • Guglin, Maya, University of Kentucky, Lexington, Kentucky, United States
Introduction

Volume overload is a major problem in patients with chronic kidney disease (CKD) and heart failure (HF). Fluid removal during dialysis treatment is the cornerstone management in these conditions but, assessing the amount of volume that should be removed is a challenge. We present two cases of remote ambulatory pulmonary artery (PA) pressure measurements in dialysis patients with HF using cardioMEMS.

Case Description

Case 1. Heart Failure with Preserved Ejection Fraction
65-year-old Caucasian female, history of type II diabetes, hypertension, CKD, hepatitis C, liver cirrhosis, NYHA class III diastolic HF. Echocardiogram left ventricular ejection fraction was (LVEF) >55%. CardioMEMS was implanted in 2016. Patient was started on intermittent hemodialysis (iHD) via a tunneled catheter in 2018. Patient was switched to continuous cyclic peritoneal dialysis (CCPD) in 2019. Her PA pressure by CardioMEMS increased after initiation of the HD but decreased significantly after CCPD was established (Figure 1).
Case 2. Heart Failure with Reduced Ejection Fraction
73-year-old Caucasian male with history of type II diabetes, hypertension, and CKD, NYHA class III systolic HF. Echocardiogram LVEF <20%. CardioMEMS was implanted in 2016. Patient had declining kidney function and a right upper arm arteriovenous fistula was placed, iHD was initiated in 2018. His PA pressure readings by CardioMEMS gradually declined after initiation of dialysis (Figure 2).

Discussion

Hemodialysis resulted in significant changes in the PA pressure in HF patients. Remote ambulatory monitoring of PA pressures is a promising strategy in dialysis patients with HF since it might guide the management of volume status and allowing early interventions.