Table 2.

Integrated backscatter used to assess myocardial fibrosis in patients with ESRD: IB, integrated backscatter; HD, hemodialysis; CKD, chronic kidney disease; INHD, incentre nocturnal hemodialysis.

Study	Patient characteristics	Results	Limitations
Losi et al. [61]	Case-control study with 25 ESRD patients on HD	Mean (±standard deviation) IB was greater in patients with ESRD than in controls (45.2 ± 8.6 dB versus 36 ± 6.1 dB; p = 0.025). A significant determinant of diastolic dysfunction as measured by echocardiography was mean IB with odds ratio of 1.212 (p = 0.04)	Small study as very selective patient criteria for inclusion
Salvetti et al. [60]	Case-control study with matched 25 HD patients, 25 patients with moderate-to-severe CKD, 10 patients with essential hypertension with normal renal function	Mean reflectivity of IB was progressively increased from 48% in patients with essential hypertension to 56% in patients with CKD to 62% in HD patients (p < 0.01) The increase in IB reflectivity indicates possible early increase in LV collagen deposition, beginning well before the development of ESRD	No histological data from biopsies to confirm fibrosis
Jin et al. [62]	Non-RCT with 58 ESRD patients on conventional HD matched with 32 INHD patients	At 12 months, mean (±standard deviation) cIB decreased significantly from −20.2 ± 3.7 dB to −28.1 ± 4.0 dB (p < 0.01) in INHD patients and cyclic variations in IB increased in INHD patients; INHD improved echocardiogram markers for myocardial fibrosis	Nonrandomised, small study with short follow-up time. No histological data from biopsies available to confirm fibrosis