<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Enhanced external counterpulsation (EECP) is provided by a noninvasive device positively affecting cardiovascular function via mechanisms called diastolic augmentation and systolic unloading. The renal aspects of EECP therapy have not been extensively investigated.</p>
</sec>
<sec><h3>Objectives</h3>
<p>To assess the effect of EECP on renal function and to determine the application in patients with kidney disease.</p>
</sec>
<sec><h3>Methods</h3>
<p>MEDLINE, EMBASE, SCOPUS, and Cochrane CENTRAL databases were searched for all studies involving EECP treatments. The title and abstract of all searched literatures were screened, and those focusing on renal outcome or conducting in kidney disease patients were selected.</p>
</sec>
<sec><h3>Results</h3>
<p>Eight studies were included in the qualitative analysis. EECP increases stroke volume, mean arterial pressure, renal artery blood flow, renal plasma flow, glomerular filtration rate (GFR), plasma atrial natriuretic peptide, urine volume, and urinary sodium chloride excretion, but reduces the plasma concentration of renin and endothelin-1 in healthy subjects. A single session of EECP after radioactive contrast exposure could provide increased contrast clearance, and this reduces contrast-induced kidney injury in patients, irrespective of previous kidney function. Thirty-five-hour sessions of EECP treatment were illustrated to increase long-term estimated GFR in patients with chronic angina and heart failure. In cirrhotic patients, EECP fails to improve GFR and renal vascular resistance. EECP device could maintain blood pressure, decrease angina symptoms, and increase cardiac perfusion in hemodialysis patients.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>EECP treatment potentially increases renal perfusion and prevents kidney injury in several conditions. EECP possibly provides beneficial effects on hemodynamics and cardiac function in hemodialysis patients.</p>
</sec>
</abstract>

Background
Enhanced external counterpulsation (EECP) is provided by a noninvasive device positively affecting cardiovascular function via mechanisms called diastolic augmentation and systolic unloading. The renal aspects of EECP therapy have not been extensively investigated.

Objectives
To assess the effect of EECP on renal function and to determine the application in patients with kidney disease.

Methods
MEDLINE, EMBASE, SCOPUS, and Cochrane CENTRAL databases were searched for all studies involving EECP treatments. The title and abstract of all searched literatures were screened, and those focusing on renal outcome or conducting in kidney disease patients were selected.

Results
Eight studies were included in the qualitative analysis. EECP increases stroke volume, mean arterial pressure, renal artery blood flow, renal plasma flow, glomerular filtration rate (GFR), plasma atrial natriuretic peptide, urine volume, and urinary sodium chloride excretion, but reduces the plasma concentration of renin and endothelin-1 in healthy subjects. A single session of EECP after radioactive contrast exposure could provide increased contrast clearance, and this reduces contrast-induced kidney injury in patients, irrespective of previous kidney function. Thirty-five-hour sessions of EECP treatment were illustrated to increase long-term estimated GFR in patients with chronic angina and heart failure. In cirrhotic patients, EECP fails to improve GFR and renal vascular resistance. EECP device could maintain blood pressure, decrease angina symptoms, and increase cardiac perfusion in hemodialysis patients.

Conclusion
EECP treatment potentially increases renal perfusion and prevents kidney injury in several conditions. EECP possibly provides beneficial effects on hemodynamics and cardiac function in hemodialysis patients.

Enhanced external counterpulsation, focusing on its effect on kidney function, and utilization in patients with kidney diseases: a systematic review

Department of Physiology, Faculty of Medicine

Clinical Research Center, Research Affairs, Faculty of Medicine

Division of Nephrology, Department of Medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Enhanced external counterpulsation (EECP) is provided by a noninvasive device positively affecting cardiovascular function via mechanisms called...

Enhanced external counterpulsation, focusing on its effect on kidney function, and utilization in patients with kidney diseases: a systematic review

Article Category: Review

Published Online: Oct 26, 2023

Page range: 208 - 221

DOI: https://doi.org/10.2478/abm-2023-0062

Keywords
cardiorenal syndrome, contrast induced nephropathy, cardiovascular disease, enhanced external counterpulsation, hemodialysis, renal function

© 2023 Thana Thongsricome et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Enhanced external counterpulsation, focusing on its effect on kidney function, and utilization in patients with kidney diseases: a systematic review

Article Category: Review

Published Online: Oct 26, 2023

Page range: 208 - 221

DOI: https://doi.org/10.2478/abm-2023-0062

Keywordscardiorenal syndrome, contrast induced nephropathy, cardiovascular disease, enhanced external counterpulsation, hemodialysis, renal function

© 2023 Thana Thongsricome et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
cardiorenal syndrome, contrast induced nephropathy, cardiovascular disease, enhanced external counterpulsation, hemodialysis, renal function