Associations between echocardiographic findings and prospective changes in residual renal function in patients new to peritoneal dialysis

Abstract

Although echocardiograms are often performed when peritoneal dialysis is started, associations between commonly reported findings and prospective changes in renal function remain understudied. Ninety-nine of 101 patients in the Trio Trial had transthoracic echocardiograms within 6 months of dialysis initiation, and measurements of residual renal function every six weeks for up to two years. Generalized mixed modelling linear regression in STATA was used to examine associations between left atrial size, left ventricular hypertrophy, left ventricular ejection fraction, right ventricular systolic pressure, and left valvular calcification with subsequent slopes in renal function. After echocardiography (performed a median of 16 days following peritoneal dialysis initiation) right ventricular systolic pressure was associated with faster, while declining left ventricular ejection fraction and valvular calcification were associated with slower declines in residual renal function. Future studies could be conducted to confirm these findings, and identify pathophysiological mechanisms.

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

“…RRF preservation is important to conserve cardiac performance, resulting in an improvement in PD patients’ clinical outcomes [ 20 ]. In a previous study [ 21 ], PD patients presented RRF every six weeks for 2 years. After echocardiography, the right ventricular systolic pressure was associated with faster RRF declines.…”