Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function

Abstract

Introduction:In patients undergoing chronic dialysis, several factors appear to influence the occurrence of cardiac abnormalities. The aim of our study was to evaluate the effects of two different methods of renal replacement therapy (chronic haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)) on left ventricular (LV) diastolic function.Patients and Methods:We enrolled 63 patients: 21 patients on CAPD, and 42 age- and gender-matched patients on HD; 35 patients were men (55.6%). Median of age was 46.4 (35-57) years. The median duration of renal replacement therapy was 3(2-5) years.Results:The two groups (HD vs PD) were similar concerning body mass index, dialysis duration and cardiovascular risk factors. The comparison of echocardiographic parameters showed statistically significant differences between two groups, regarding the presence of calcification, cardiac effusion, severely abnormal left ventricular hypertrophy(LVH) and the ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/e’) >13 (p= 0.001, p= 0.003, p= 0.02, p= 0.004, respectively). In multivariate analysis, an E/e’>13 was higher in PD group ( OR= 5.8, CI [1.3-25.5], p=0.002).Conclusion:The method of dialysis seems to influence LV diastolic function. We observed a higher prevalence of diastolic LV dysfunction in the PD group. Echocardiographic follow up is essential as this could improve the management of cardiovascular complications in dialysis patients.

Heart remodeling and quality of life in patients with chronic kidney disease on renal replacement therapy

“…The highest values of LVMI were observed in patients on HD and CAPD. Moreover, as in some other studies, the severity of LVH was higher in patients on HD [17,18]. The mean LVMI values were normal in kidney transplant recipients, regardless of gender.…”

The Impact of Dialysis Modality on Left Ventricular Function in Patient with End Stage Kidney Disease

“…3 In the present study we found that LVH and LVM were higher in HD group than PD patients and was statistically significant. Similar findings of a high prevalence of LVH in HD patients were seen in a study done by Kimura et al 13 , and Tian et al 18 On the contrary, a study was done by Ellouli et al 19 showed a higher prevalence of LVH in PD patients. Our study contradicts earlier data by Enia et al showing higher prevalence of LVH and LVM in PD patients.…”

“…Similar findings were observed in a study done by Alpert et al 23 However, Ellouali et al, showed a higher frequency of pericardial effusion in their study. 19 The reason for the higher incidence of effusion can be caused by fluid overload with or without congestive heart failure in HD patients, a situation unlikely to develop during effective CAPD. It is also possible that CAPD provides better clearance than hemodialysis of toxins potentially responsible for pericarditis in renal failure.…”

Cardiac geometry, function, and remodeling patterns in patients under maintenance hemodialysis and peritoneal dialysis treatment

“…Possible differences in LV systolic or diastolic performance and RV echocardiographic indices have not been evaluated in any of these studies. Only in one case–control study including 21 PD and 42 age‐ and gender‐matched hemodialysis patients, the diastolic function was evaluated with one index and results showed similar LV and RV geometry indices between the two groups, but higher prevalence of LVH (23.8% vs. 42.9%; p = 0.02) and diastolic dysfunction, indicated by E/e′ ≥ 13 (11.9% vs. 38.1%; p = 0.004), in PD compared with hemodialysis patients [36].…”