Left ventricular function in end stage renal disease--non-invasive assessment in patients on maintenance hemodialysis.

Non-invasive assessment of left ventricular function was performed by echocardiography and radionuclide ventriculography in 17 end-stage renal disease patients on maintenance hemodialysis. Patients with diabetes mellitus, ischemic heart disease and pericardial or valvular heart disease were excluded from the study. Parameters studied on echocardiography were left ventricular internal diameter in diastole (LVIDd), left atrial diameter (LAD), Aortic root diameter (ARD), Left ventricular posterior wall thickness in systole (LVPWs), End diastolic volume (EDV), End Systolic volume (ESV), fractional shortening percentage (FS%) and ejection fraction (EF). Parameters studied on radionuclide ventriculography were Peak ejection rate (PER), Peak filling rate (PFR) and Ejection fraction (EF). Significantly abnormal values for echocardiographic parameters LVIDd, LVPWs, EDV, ESV and FS% were found. On evaluation by MUGA scans, it was observed that the PER was significantly decreased while the PFR and EF did not change significantly.

Pregnancy and lupus nephritis.

We retrospectively studied 10 patients with systemic lupus erythematosus (SLE)-seen between October 1981 and October 1989-who underwent 29 pregnancies to assess the influence of SLE on the outcome of pregnancy and the effects of pregnancy on the course of lupus nephritis. Nineteen gestations occurred before the diagnosis of SLE was made, 7 after and in 3 cases it wasmade in the second trimester of pregnancy. Out of 29 pregnancies, 12 were successful, 16 unsuccessful and 1 patient underwent a medical termination of pregnancy (MTP). A history of repeated abortions prior to the diagnosis of SLE was obtained in 2 patients. When the disease had been in remission for 6 months, 5 successful pregnancies occurred. Two patients showed a rise in plasma creatinine and developed severe hypertension during the third trimester. Weconclude that a prior history of repeated abortions may be one of the manifestations of underlying SLE. In these patients successfuloutcome of conception without deterioration of maternal renal function may be obtained provided gestation occurs during a period of sustained remission.