[A comparative evaluation of the central hemodynamic indices in patients with the terminal stage of kidney failure during dialysis therapy and allografting].

Changes of the functional indices of central and intracardiac hemodynamics during treatment with hemodialysis or peritoneal dialysis, as well as after cadaver kidney transplantation, were studied in 44 patients with the terminal stage of chronic renal failure by means of radiocardiography with 131I-albumin. The signs of cardiac insufficiency were evaluated according to the classes of the cardiologists' New York classification accepted in 1964. Four groups of patients were distinguished during the analysis: group 1-10 patients given intravenous detoxification therapy; group 2-19 patients treated by chronic programmed hemodialysis; group 3-4 patients kept on peritoneal dialysis; group 4-11 patients after allotransplantation of cadaver kidney. It was found that in group 1 patients the indices of central (mean arterial pressure, cardiac and stroke indices, total peripheral vascular resistance, work of the left ventricle) and intracardiac (time of circulation of blood in the heart cavities and lungs) hemodynamics were on the upper normal values and in occasional cases exceeded it. In patients of group 2 the indices of intracardiac hemodynamics grew worse and required an individual approach to the hemodialysis regimens with due account for the volemic disorders. In group 3 some indices of central and intracardiac hemodynamics corresponded to those in group 2, but the circulation volume, and mean arterial pressure were normal, which was reflected by better subjective tolerance to peritoneal dialysis. Analysis of indices in group 4 patients showed improvement of normalization of most parameters of central and intracardiac hemodynamics with gradual increase of diuresis, and abatement of the clinical signs of cardiac insufficiency after successful transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)