A longitudinal study of cardiac structure and function using echocardiography in patients undergoing peritoneal dialysis

Abstract

Background Peritoneal dialysis (PD) can be associated with abnormal cardiac structure and function and increased mortality risk. Therefore, in this study, we analyzed the cardiac structure and function dynamic changes using echocardiography during the first 2 years of PD therapy. We also assessed its associations with all-cause mortality risk after 2 years of follow-up. Methods End-stage renal disease (ESRD) patients that have started PD from 2011 to 2017, and had echocardiography at baseline and years 1 and 2, were included in this study. Echocardiographic parameters were compared between baseline and year 2. Multivariable Cox models were used to estimate the association between echocardiographic parameters changes and all-cause mortality risk. Results We finally enrolled 72 PD patients in this study. The mean right ventricular diameter (RVD) increased from baseline (18.31 mm) to year 1 (18.75 mm) and year 2 (19.65 mm). We also observed a significant decrease in cardiac output (CO) between baseline and year 2. Additionally, a slight decrease trend in ejection fraction (EF) was observed. Finally, every 1 % increase in RVD was associated with a 68.2 % higher mortality risk after dialysis (HR, 1.682; 95 % CI, 1.017–2.783). Conclusions Our results demonstrated a susceptibility for deteriorated right cardiac structure and function during the first 2 years of PD treatment. Also, higher all-cause mortality risk was observed after 2 years of PD. Altogether, these results highlighted the need for additional focus on regular echocardiographic examinations during long-term PD management. Trial registration The PD-CRISC cohort, registered with the Chinese Clinical Trial Registry (ChiCTR1900023565).

Left ventricular strain and myocardial work in short-term peritoneal dialysis patients

“…Previous studies have investigated cardiovascular risk in dialysis patients, yet only a few have focused on cardiovascular risk in the early period after the initiation of chronic dialysis [ 9 , 10 ]. Indeed, mortality in the initial 90 days of chronic dialysis is high, particularly in the first two weeks [ 11 ].…”

Left atrial and ventricular deformation: alterations and predictive value of echocardiography parameters in end-stage renal disease patients after kidney transplantation

“… 1 This higher risk is due to not only the higher prevalence of conventional risk factors but also by uraemia, electrolyte abnormalities, and haemodynamic factors 1 , 2 These factors have been found to impact the left ventricle (LV) resulting in structural and functional changes in the heart. 1 , 3 …”