Long‐term CAPD patients are volume expanded and display more severe left ventricular hypertrophy than haemodialysis patients

Enia, Giuseppe; Mallamaci, Francesca; Benedetto, Francesco; Panuccio, Vincenzo; Parlongo, Saverio; Cutrupi, Sebastiano; Giacone, Giuseppe; Cottini, E; Tripepi, Giovanni; Malatino, Lorenzo; Zoccali, Carmine

doi:10.1093/ndt/16.7.1459

Cited by 179 publications

(156 citation statements)

References 20 publications

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“…There is a need for further research in this area, especially given that LVH is more common amongst long-term PD patients compared to haemodialysis patients. 55 …”

Section: What Is the Evidence-base Amongst Peritoneal Dialysis Patients?mentioning

confidence: 99%

The significance of serum troponin T in patients with kidney disease: a review of the literature

2004

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The last 10 years have witnessed radical changes in the de nition and diagnosis of the acute coronary syndrome (ACS), including myocardial infarction, as a result of the introduction of sensitive and speci c markers of myocardial damage, the cardiac troponins. One barrier to the universal acceptance of these markers has been the observation that troponin T (cTnT) concentration is commonly increased in the presence of renal failure. Initially it was believed that this constituted an important false positive limitation of the test. This was confounded by problems with the initial cTnT assay and by the observation that troponin I (cTnI) was generally not increased in these patients. However, it has recently been demonstrated that the prognostic signi cance of a raised cTnT concentration in patients with a suspected ACS is unaffected by renal impairment. Further, powerful outcome studies are now being reported demonstrating that raised concentrations of serum cTnT are predictive of mortality in haemodialysis patients. This review summarizes our current understanding of the prevalence and signi cance of raised serum cTnT concentrations in patients with kidney disease and highlights areas where our understanding is incomplete. Evidence suggests that raised troponin concentrations in uraemic patients do indeed re ect myocardial injury. In the future, patients demonstrating this abnormality may be the target for more aggressive cardiac intervention, the advantages of which have been demonstrated in the non-uraemic population.

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“…There is a need for further research in this area, especially given that LVH is more common amongst long-term PD patients compared to haemodialysis patients. 55 …”

Section: What Is the Evidence-base Amongst Peritoneal Dialysis Patients?mentioning

confidence: 99%

The significance of serum troponin T in patients with kidney disease: a review of the literature

2004

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“…Anemia, mineral and bone disorders, the inflammation-muscular-wasting complex, cardiomyopathy, neuropathy, and depression, all disturbances that frequently coexist in CKD-5D, may be involved in the poor physical functioning of this population (3)(4)(5)(6). Pulmonary congestion detected and quantified by lung ultrasonography recently emerged as a powerful correlate of poor physical functioning in a multicenter study in peritoneal dialysis (PD) patients (7), a population with an exceedingly high prevalence of fluid overload and left ventricular dysfunction (8)(9)(10), suggesting that volume expansion and cardiomyopathy, two potentially reversible risk factors, play a major role in the poor physical performance of this population.…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients

Enia

Torino²,

Panuccio

et al. 2013

Clinical Journal of the American Society of Nephrology

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Summary Background and objectives Poor physical performance is common in patients with kidney failure on dialysis (CKD-5D). Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical performance of CKD-5D patients has not been investigated in hemodialysis patients. Design, setting, participants, & measurements This study investigated the relationship between the physical functioning scale of the Kidney Disease Quality of Life Short Form and a validated ultrasonographic measure of lung water in a multicenter survey of 270 hemodialysis patients studied between 2009 and 2010. Results Moderate to severe lung congestion by lung ultrasonography was observed in 156 (58%) patients; among these, 60 (38%) were asymptomatic (New York Heart Association [NYHA] class I). On univariate analysis, physical functioning was inversely associated with lung water in the whole group (r=−0.22; P<0.001) and in the subgroup of asymptomatic patients (r=−0.40; P=0.002). Age (r=−0.45; P<0.001) and past cardiovascular events (r=−0.22; P=0.002) were also inversely associated with physical functioning, whereas albumin (r=0.23; P<0.001) was directly associated with the same parameter. NYHA class correlated strongly with physical functioning (r=−0.52; P<0.001). In a multiple regression analysis, both NYHA class and lung water maintained an independent association with physical functioning, whereas albumin and background cardiovascular events failed to independently relate with the same outcome. Conclusions Symptomatic and asymptomatic lung congestion is associated with poor physical functioning in hemodialysis patients. This association is independent of NYHA, suggesting that this measurement and NYHA may have complementary value to explain the variability in physical performance in hemodialysis patients.

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“…In summary, these studies showed clearly that IDH was an independent subtype of hypertension in clinics. It should be noted that certain indices of fluid status, such as the cardiac and thoracic ratio (CTR), Vena Cava diameter or atrial natriuretic peptide levels, would have contributed greatly to the present analysis, had they been available, since fluid overload is widely recognized to play an important role in the pathogenesis of hypertension in dialysis patients (36). A previous study has shown that fluid overload is very common in dialysis patients (36), and hypertensive dialysis patients usually have more extracellular water than normotensive dialysis patients (37).…”

Section: Isolated Diastolic Hypertension: An Independent Subtype Of Hmentioning

confidence: 99%

“…It should be noted that certain indices of fluid status, such as the cardiac and thoracic ratio (CTR), Vena Cava diameter or atrial natriuretic peptide levels, would have contributed greatly to the present analysis, had they been available, since fluid overload is widely recognized to play an important role in the pathogenesis of hypertension in dialysis patients (36). A previous study has shown that fluid overload is very common in dialysis patients (36), and hypertensive dialysis patients usually have more extracellular water than normotensive dialysis patients (37). Whether fluid status also has some effect on aortic stiffness is not clear at present, but we believe that the availability of these indices would help us to understand more, if not all, about the underlying mechanism of the present findings.…”

Section: Isolated Diastolic Hypertension: An Independent Subtype Of Hmentioning

confidence: 99%

The Study of Aortic Stiffness in Different Hypertension Subtypes in Dialysis Patients

et al. 2008

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The aim of this study was to validate whether differences in aortic stiffness are responsible for the differences in cardiovascular mortality among hypertension subtypes. Twenty hundred and fifty continuous ambulatory peritoneal dialysis patients were included in the present study. They were classified into four groups: normotensives (n =92) with systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg; isolated systolic hypertensives (ISH, n =84) with SBP ≥140 mmHg and DBP <90 mmHg; isolated diastolic hypertensives (IDH, n =21) with SBP <140 mmHg and DBP ≥90 mmHg; and systolic-diastolic hypertensives (SDH, n =53) with SBP ≥140 mmHg and DBP ≥90 mmHg. Aortic stiffness was assessed by pulse pressure, central pressure parameters and pulse wave velocity. The IDH group had more male patients and a lower mean age than the other groups. The percentage of diabetes in the ISH group was higher than that in the other groups. The comparisons of aortic stiffness showed that the ISH and SDH groups had higher aortic stiffness than the normotension and IDH groups. The aortic stiffness in the ISH group was also higher than that in the SDH group, but there was no significant difference in aortic stiffness between the normotension and IDH groups. In conclusion, this study showed that aortic stiffness was significantly different among different hypertension subtypes, which might be an underlying cause of the differences in cardiovascular mortality among the hypertension subtypes. (Hypertens Res 2008; 31: 593-599)

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Long‐term CAPD patients are volume expanded and display more severe left ventricular hypertrophy than haemodialysis patients

Cited by 179 publications

References 20 publications

The significance of serum troponin T in patients with kidney disease: a review of the literature

The significance of serum troponin T in patients with kidney disease: a review of the literature

Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients

The Study of Aortic Stiffness in Different Hypertension Subtypes in Dialysis Patients

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