Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients

Cader, Rizna Abdul; Ibrahim, Osama; Paul, Samir Kumar; Gafor, Abdul Halim Abdul; Mohd, Rozita

doi:10.1007/s11255-013-0615-8

Cited by 14 publications

(12 citation statements)

References 40 publications

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“…Although cautious interpretation is warranted given the small number of cohorts including echocardiogram data, our findings add weight to the developing narrative that cardiac structural disease, particularly left ventricular systolic dysfunction (LVSD), may not be the sine qua non underlying excess mortality in overhydrated ESKF patients. The link between BI-OH and adverse cardiovascular events has been previously noted; BI-OH previously being correlated with endothelial dysfunction 72 , arterial stiffness 43 and the development of left ventricular hypertrophy (LVH 73 , 74 ). In studies exploring sudden cardiac death in ESKF, LVH was predictive of mortality even when adjusting for blood pressure, whereas LVSD played no such role in predicting mortality.…”

Section: Discussionmentioning

confidence: 96%

Bioimpedance-defined overhydration predicts survival in end stage kidney failure (ESKF): systematic review and subgroup meta-analysis

Tabinor

Elphick

Dudson

et al. 2018

Sci Rep

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Both overhydration and comorbidity predict mortality in end-stage kidney failure (ESKF) but it is not clear whether these are independent of one another. We undertook a systematic review of studies reporting outcomes in adult dialysis patients in which comorbidity and overhydration, quantified by whole body bioimpedance (BI), were reported. PubMed, EMBASE, PsychInfo and the Cochrane trial database were searched (1990–2017). Independent reviewers appraised studies including methodological quality (assessed using QUIPS). Primary outcome was mortality, with secondary outcomes including hospitalisation and cardiovascular events. Of 4028 citations identified, 46 matched inclusion criteria (42 cohorts; 60790 patients; 8187 deaths; 95% haemodialysis/5% peritoneal dialysis). BI measures included phase angle/BI vector (41%), overhydration index (39%) and extra:intracellular water ratio (20%). 38 of 42 cohorts had multivariable survival analyses (MVSA) adjusting for age (92%), gender (66%), diabetes (63%), albumin (58%), inflammation (CRP/IL6–37%), non-BI nutritional markers (24%) and echocardiographic data (8%). BI-defined overhydration (BI-OH) independently predicted mortality in 32 observational cohorts. Meta-analysis revealed overhydration >15% (HR 2.28, 95% CI 1.56–3.34, P < 0.001) and a 1-degree decrease in phase angle (HR 1.74, 95% CI 1.37–2.21, P < 0.001) predicted mortality. BI-OH predicts mortality in dialysis patients independent of the influence of comorbidity.

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Section: Discussionmentioning

confidence: 96%

Bioimpedance-defined overhydration predicts survival in end stage kidney failure (ESKF): systematic review and subgroup meta-analysis

Tabinor

Elphick

Dudson

et al. 2018

Sci Rep

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“…Hypohydration in older adults living in the community is widely considered to be common (24), although some contention exists within the literature as to the accuracy of these beliefs (10). Hyperhydration is considered rare in otherwise healthy individuals, with the majority of reports of excess body fluid due to polydipsia (intake >3 liters fluid per day) associated with mental illness (25, 26) or those undergoing medical care as in diabetes and dialysis (27–29). …”

Section: Water In the Bodymentioning

confidence: 99%

Systemic Hydration: Relating Science to Clinical Practice in Vocal Health

Hartley

Thibeault

2014

Journal of Voice

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Objectives To examine the current state of the science regarding the role of systemic hydration in vocal function and health. Study Design Literature Review Methods Literature search spanning multiple disciplines, including speech-language pathology, nutrition and dietetics, medicine, sports and exercise science, physiology and biomechanics. Results The relationship between hydration and physical function is an area of common interest amongst multiple professions. Each discipline provides valuable insight into the connection between performance and water balance, as well as complimentary methods of investigation. Existing voice literature suggests a relationship between hydration and voice production, however the underlying mechanisms are not yet defined and a treatment effect for systemic hydration remains to be demonstrated. Literature from other disciplines sheds light on methodological shortcomings and in some cases offers an alternative explanation for observed phenomena. Conclusions A growing body of literature in the field of voice science is documenting a relationship between hydration and vocal function, however greater understanding is required to guide best practice in the maintenance of vocal health and management of voice disorders. Integration of knowledge and technical expertise from multiple disciplines facilitates analysis of existing literature and provides guidance as to future research.

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“…These results lead to the opinion that besides inadequate removal of uremic toxins, overhydration could still be the main mechanism for progression of LVH in our study patients. Recently, Cader et al clearly demonstrated that the overhydration is strongly associated with LVH in PD patients [19]. Furthermore, a recent study during a 6-month follow-up further supports the presumption of positive effect of volume control in dialysis patients using clinical routine by segmental calf bioimpedance spectroscopy (cBIS) for dry weight assessment.…”

Section: Discussionmentioning

confidence: 86%

The Effect of Preserved Residual Renal Function on Left Ventricular Structure in Non-Anuric Peritoneal Dialysis Patients

Rebić

Matovinović

Rašić

et al. 2015

Kidney Blood Press Res

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Background/Aims: Residual renal function (RRF) has been shown to influence survival of peritoneal dialysis (PD) patients. This study examined the relations between RRF and left ventricular hypertrophy (LVH) before switching on dialysis treatment and observed during 18 months on PD treatment. Methods: A prospective longitudinal study was performed in 50 non-anuric (defined as >200 mL urine output in a 24-hour period) PD patients. Echocardiography, RRF and other known risk factors for the increase of LV mass index (LVMi) were determined at study baseline and the end of follow-up. Results: There was 78% patients with LVH in end-stage renal disease (ESRD) baseline and 60% at the end of follow-up. RRF at the start of the study showed no significant difference between patients with normal and increased LVMi, as well as in daily collection of urine. After 18 months, patients with decreased LVMi had better RRF, lower CRP and better Kt/V compared to patients with increased LVMi (p < 0.001). Patients with better preserved RRF not only had significantly higher total Kt/V, but were less anemic and hypoproteinemic and lesser presence of LVH. Conclusions: PD in non-anuric ESRD patients the first 18 months has a positive effect on the preservation of RRF and partial regression of left ventricular remodeling.

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Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients

Abstract: Overhydration is strongly associated with LVH in PD patients.

Cited by 14 publications

References 40 publications

Bioimpedance-defined overhydration predicts survival in end stage kidney failure (ESKF): systematic review and subgroup meta-analysis

Bioimpedance-defined overhydration predicts survival in end stage kidney failure (ESKF): systematic review and subgroup meta-analysis

Systemic Hydration: Relating Science to Clinical Practice in Vocal Health

The Effect of Preserved Residual Renal Function on Left Ventricular Structure in Non-Anuric Peritoneal Dialysis Patients

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