NEWS Dialysis is a life-sustaining treatment for patients whose kidneys have stopped functioning. A new doctoral thesis from Umeå University shows that dialysis can alter the levels of blood biomarkers used to detect heart injury and that the blood flow in the vascular access used for treatment may influence the risk of developing heart failure.
Emelie Laveborn is a doctoral student at the Department of Public Health and Clinical Medicine at Umeå University. Her thesis provides important and clinically useful knowledge that may improve the interpretation of diagnostic tests and risk assessment in patients undergoing dialysis.
ImageHans KarlssonDialysis is a life-sustaining treatment for patients whose kidneys have stopped functioning. A new doctoral thesis from Umeå University shows that dialysis can alter the levels of blood biomarkers used to detect heart injury and that the blood flow in the vascular access used for treatment may influence the risk of developing heart failure.
“If clinicians are unaware that dialysis itself impacts the levels of biomarkers, they may misinterpret blood samples taken shortly after a dialysis session, for example when investigating a possible heart attack,” says Emelie Laveborn, doctoral student at the Department of Public Health and Clinical Medicine at Umeå University.
Dialysis is a life-sustaining treatment that replaces some kidney functions when the kidneys fail. In Sweden, approximately 3,000 people receive haemodialysis each year. Unfortunately, even optimal treatment is associated with an increased risk of cardiovascular disease and premature death. In her thesis, Emelie Laveborn examined how both haemodialysis itself and the vascular access required for treatment affect the heart.
One part of her work investigated how different biomarkers of cardiac injury are affected by dialysis treatment. She found that dialysis itself places stress on the heart. This is reflected in rising levels of cardiac injury biomarkers in the blood when dialysis filters that do not remove these biomarkers are used. She also found that cardiac injury biomarker levels decrease with the dialysis methods most commonly used in clinical practice.
When the kidneys fail, urine production eventually ceases, and all excess fluid taken in by the patient must be removed through dialysis. It is well known that fluid overload places strain on the heart. There are also indications that removing fluid too rapidly may be harmful. However, among patients who tolerated treatment well, Emelie Laveborn found no difference in the increase of cardiac injury biomarkers when she actively reduced the rate at which fluid was removed.
The thesis showed that it is not only the dialysis treatment itself that may affect the heart. The vascular access required for treatment may also play an important role.
The second part of the thesis focused on the vascular access required for haemodialysis. This access is often described as the patient’s lifeline. The preferred way of creating it is to connect a vein directly to an artery, thereby creating a vessel with high blood flow, known as an arteriovenous (AV) access. However, a growing body of evidence suggests that these accesses may negatively affect the heart and that the risk could be greater when the access is created in the upper arm, where larger blood vessels may result in higher access blood flow.
“In my studies, I found that the use of upper-arm AV accesses increased in Sweden. However, we did not observe any difference in the risk of being diagnosed with heart failure depending on whether the access was located in the upper arm or the forearm,” says Emelie Laveborn.
The blood flow through the access itself, however, appears to influence the risk of heart failure.
“This is one of the factors that may need to be considered when determining which type of vascular access is most suitable for an individual patient.”
In Sweden, approximately 3,000 people receive haemodialysis each year.
ImageMostphotosThere are two forms of dialysis: peritoneal dialysis (also known as CAPD or bag dialysis), which takes place inside the body, and haemodialysis. Haemodialysis is the most common form of treatment and involves filtering and cleansing venous blood in a special dialysis machine outside the body. This is achieved by passing the blood through a membrane, a plastic filter containing microscopic pores.
On Friday, 23 October 2026, Emelie Laveborn, Department of Public Health and Clinical Medicine, Umeå University, will defend her doctoral thesis entitled Cardiac Implications of Haemodialysis and Vascular Access. The public defence will take place at 1:00 p.m. in Betula Lecture Hall, Norrland University Hospital. The opponent will be Associate Professor Marie Evans, Karolinska Institutet.
