A novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients

Wang, Angela Yee-Moon; Wang, Mei; Woo, Jean; Law, Man-Ching; Chow, Kai‐Ming; Li, Philip Kam-Tao; Lui, Siu‐Fai; Sanderson, John E.

doi:10.1046/j.1523-1755.2002.00471.x

Cited by 173 publications

(161 citation statements)

References 43 publications

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“…Wang et al found that left ventricular mass increased in peritoneal dialysis patients who had lower glomerular filtration rates. 9 However, these authors found similar end diastolic diameters among the assessed groups, which differs from the findings in our study. One of the possible reasons for these different findings could be due to the type of dialysis, while another reason may be that the authors did not correlate modifications in the left ventricle with the residual 24-hour urinary volume of their patients.…”

Section: Discussioncontrasting

confidence: 99%

“…5 During the conservative management of patients with CKD, 6 it was observed that the decline in the glomerular filtration rate was associated with left ventricular hypertrophy (LVH). [7][8][9][10][11] The presence of LVH, in turn, constitutes an important independent factor for cardiovascular risk in patients with CKD. 7,8,12,13 Patients in renal replacement therapy (stage V) 6 may have larger or smaller residual renal function (RRF) declines depending on the diastolic method used.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] The progressive reduction in renal function is associated with LVH and greater cardiovascular mortality in PD patients. 12,18,19 In various studies, the presence of LVH was related to hemodialysis treatment; 9,10,12,20,21 however, few studies have reported a relationship between LVH and the morphological and functional aspects of the left ventricle with different volumes of residual diuresis. Accordingly, the objectives of this study were to verify possible cardiac morphological and functional differences in the left ventricle in patients with or without residual dieresis on chronic hemodialysis treatment.…”

Section: Introductionmentioning

confidence: 99%

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Morfologia e função cardíacas em pacientes renais crônicos, com ou sem diurese residual, em tratamento hemodialítico

Araújo¹,

Lemes²,

Cunha³

et al. 2011

J. Bras. Nefrol.

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In patients with chronic renal failure on hemodialysis, left ventricular hypertrophy is related to the increase in total peripheral vascular resistance and volume overload. The presence of residual diuresis enables greater control of the volemia of these. We evaluated the morpho-functional changes of the left ventricle in patients with chronic kidney disease on hemodyalisis treatment with and without residual diuresis. A total of 31 non diabetic patients were studied and they were divided into two groups: with residual diuresis (RD+) (n = 17) and without residual diuresis (RD-) (n = 14). In both groups, RD+ vs. RD-, using data from a Doppler echocardiogram differences were found, respectively, in the cardiac index (3.9 ± 0.2 vs. 3.0 ± 0.2 L/min/m 2 ; p = 0.0056), systolic index (54 ± 2.9 vs. 45 ± 3.3 mL/b/m 2 ; p = 0.04), end diastolic volume (141 ± 6.7 vs. 112 ± 7.6 mL; p = 0.008), end diastolic diameter (52 ± 0.7 vs. 48 ± 1.1 mm; p = 0.0072) and total peripheral resistance index (1121 ± 56 vs. 1529 ± 111 dyne.sec.cm -5 ; p = 0.001). RD+ had lower relative wall thickness than RD-(0.38 ± 0.01 vs. 0.45 ± 0.01; p = 0.0008). The ejection fraction and the left ventricular mass index were similar in both groups. The urinary 24-hour volume correlated with the relative wall thickness (r = -0.42; p = 0.0186) and with peripheral resistance index (r = -0.48; p = 0.0059). In conclusion, there were distinct ventricular geometric patterns and different functional performances between RD+ and RD-groups. The presence of residual diuresis can be responsible by these modifications in systolic function.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Morfologia e função cardíacas em pacientes renais crônicos, com ou sem diurese residual, em tratamento hemodialítico

Araújo¹,

Lemes²,

Cunha³

et al. 2011

J. Bras. Nefrol.

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“…In addition, the need for dietary and fluid restriction is reduced, which may partly explain their better nutritional state (8) and quality of life (9). In terms of clinical outcomes, the degree of RRF has been inversely associated with left ventricular hypertrophy, independent of blood pressure or anemia level (10). Moreover RRF has been associated with improved survival in hemodialysis (HD) and peritoneal dialysis (PD) patients (11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Role of Residual Renal Function in Phosphate Control and Anemia Management in Chronic Hemodialysis Patients

Penne

Weerd

Grooteman

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives There is increasing awareness that residual renal function (RRF) has beneficial effects in hemodialysis (HD) patients. The aim of this study was to investigate the role of RRF, expressed as GFR, in phosphate and anemia management in chronic HD patients.Design, setting, participants, & measurements Baseline data of 552 consecutive patients from the Convective Transport Study (CONTRAST) were analyzed. Patients with a urinary output Ն100 ml/24 h (n ϭ 295) were categorized in tertiles on the basis of degree of GFR and compared with anuric patients (i.e., urinary output Ͻ100 ml/24 h, n ϭ 274). Relations between GFR and serum phosphate and erythropoiesis-stimulating agent (ESA) index (weekly ESA dose per kg body weight divided by hematocrit) were analyzed with multivariable regression models.Results Phosphate levels were between 3.5 and 5.5 mg/dl in 68% of patients in the upper tertile (GFR Ͼ 4.13 ml/min per 1.73 m 2 ), as compared with 46% in anuric patients despite lower prescription of phosphate-binding agents. Mean hemoglobin levels were 11.9 Ϯ 1.2 g/dl with no differences between the GFR categories. The ESA index was 31% lower in patients in the upper tertile as compared with anuric patients. After adjustments for patient characteristics, patients in the upper tertile had significantly lower serum phosphate levels and ESA index as compared with anuric patients. ConclusionsThis study suggests a strong relation between RRF and improved phosphate and anemia control in HD patients. Efforts to preserve RRF in HD patients could improve outcomes and should be encouraged.

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“…In our study, a significant relationship was found between total KtV and total UF. LVH has been inversely related to residual KtV, with higher LVH in anuric patients than in patients with residual diuresis 24,25 . The CANUSA study showed that each 250 ml of urine shows a 36% decrease in overall mortality 26,27 .…”

Section: Discussionmentioning

confidence: 99%

Compromiso cardiovascular en pacientes pediátricos en diálisis peritoneal crónica

2017

Rev. chil. pediatr.

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Peritoneal dialysis (PD) is the most common renal replacement therapy used in pediatric patients with end stage renal disease. This population has a mortality rate 1,000 times greater compare to pediatric population, mainly due to cardiovascular causes. Objective: To characterize pediatric patients on chronic PD in relation to dialysis and cardiovascular outcome. Patients and Methods: Cross sectional study. Patients in stable PD according to DOQI criteria were selected. Epidemiological, dialytic, biochemical and cardiovascular variables were registered. Left Ventricular Mass Index (LVMI) was calculated by height/age (g/m 2.7 ). Left Ventricular Hypertrophy (LVH) was diagnosed with > 38.6 g/m 2.7 , severe LVH > 51 g/m 2.7 . Data were analyzed using STATA 11.0. continuous variables using ANOVA test and categorical variables were analyzed using c 2 test or Fisher's exact test. Results: 21 patients, 11 males. Mean age 9.2 ± 3.52 years. The most frequent diagnosis was renal dysplasia (52%). Residual and Peritoneal KtV were 0.8 and 1.9 respectively. Fifty-two percent of patients showed LVH, 91% in severe range. A significant relationship between ultrafiltration/m2 and systolic blood pressure was depicted. Also a significant relationship between left ventricular mass index and hemoglobin (p < 0.05) was founded. Conclusions: The majority of the population showed left ventricular hypertrophy -particularly severe LVH-, which confirms an increased CV risk in this population. Blood pressure and loss of ultrafiltration were founded to be correlated to LVH.

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A novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients

Cited by 173 publications

References 43 publications

Morfologia e função cardíacas em pacientes renais crônicos, com ou sem diurese residual, em tratamento hemodialítico

Morfologia e função cardíacas em pacientes renais crônicos, com ou sem diurese residual, em tratamento hemodialítico

Role of Residual Renal Function in Phosphate Control and Anemia Management in Chronic Hemodialysis Patients

Compromiso cardiovascular en pacientes pediátricos en diálisis peritoneal crónica

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