Association of left ventricular systolic dysfunction with mortality in incident peritoneal dialysis patients

Wang, Yating; Xiong, Liping; Xu, Qingdong; Li, Wei; Peng, Xuan; Shen, Jason; Qiu, Yagui; Yu, Xueqing; Mao, Haiping

doi:10.1111/nep.13154

Cited by 5 publications

(9 citation statements)

References 31 publications

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“…The prevalence of LVSD in our CA patients with PD was 16%, similar to the Thai CAPD population (17.48%) (14). They are much larger than in incident CA patients with PD (6.6%) (3). A study of stable patients with PD and LVSD indicated that the odds ratios for death were 1.93 (3).…”

Section: Discussionmentioning

confidence: 88%

“…The prevalence of LVSD in the dialysis population is much greater than in the general population (3,21,22). The prevalence of LVSD in our CA patients with PD was 16%, similar to the Thai CAPD population (17.48%) (14).…”

Section: Discussionmentioning

confidence: 99%

“…Peritoneal dialysis (PD) is considered to be a vital method for renal replacement therapy in end-stage renal disease (ESRD), and cardiovascular disease (CVD) events are the leading causes of death in patients with PD (1)(2)(3). Several studies revealed that reduced left ventricular ejection function (LVEF) is significantly associated with increased all-cause and cardiovascular mortality in patients with PD (3)(4)(5)(6)(7). Therefore, changes in left ventricular function, such as LVEF, are essential for patients with PD.…”

Section: Introductionmentioning

confidence: 99%

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Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis

et al. 2022

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BackgroundReduced left ventricular ejection function (LVEF) was associated with increased mortality in patients with peritoneal dialysis (PD) in Asia and the United States of America. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were correlated with LVEF in PD. However, little information is available regarding the relationship between monocyte-to-lymphocyte ratio (MLR), left ventricular ejection fraction (LVEF), and the use of NLR, PLR, and MLR in predicting left ventricular systolic dysfunction (LVSD) in patients with PD.MethodsAll 181 patients with PD were enrolled between 2014 and 2021 from the Nephrology Department of the First Affiliated Hospital of the University of South China. Demographic features, clinical characteristics, laboratory values, and echocardiographic parameters were collected.ResultsThe mean age of patients with PD was 47.4 ± 12.6, and 90 (49.7%) of the patients were men. LVEF showed a negative correlation with PLR (r = −0.200, p = 0.007) and MLR (r = −0.146, p = 0.049). The levels of NLR, PLR, and MLR were elevated in patients with PD with LVSD compared with those without (all p < 0.05). PLR (OR 4.331, 95% CI: 1.223, 15.342) and albumin (OR 13.346, 95% CI: 3.928, 45.346) were significantly associated with LVSD patients with PD in the multivariate logistic analysis. For differentiating patients with PD with LVSD, optimal cutoffs of NLR, PLR, MLR, and albumin were 4.5 (sensitivity: 76.7%, specificity: 55.0%, and overall accuracy: 58%), 202.6 (sensitivity: 66.7%, specificity: 69.5%, and overall accuracy: 69%), 0.483 (sensitivity: 53.3%, specificity: 72.8%, and overall accuracy: 30%), and 34.6 (sensitivity: 72.2%), respectively.ConclusionsOur results revealed that PLR was better than NLR, MLR, and albumin in predicting LVSD in PD.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis

et al. 2022

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“…Subgroup analyses were also performed with respect to LVEF. Previous studies (20)(21)(22) suggested that patients with HFrEF had a poorer prognosis. We used Kaplan-Meier survival curve and Cox regression model to compare the survival difference between patients ≤ 65 years old and >65 years old.…”

Section: Methodsmentioning

confidence: 96%

Impact of dialysis modality choice on the survival of end-stage renal disease patients with congestive heart failure in southern China: A retrospective cohort study

Liang²,

Huang³

et al. 2022

Front. Med.

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Background and objectHeart failure is one of the common complications in patients with end-stage renal disease (ESRD) and a major cause of death in these patients. The choice of dialysis modality for ESRD patients with congestive heart failure (CHF) is still inconclusive. The purpose of this study was to compare the prognosis of hemodialysis (HD) and peritoneal dialysis (PD) among ESRD patients with CHF and provide a basis for clinical decision-making.Materials and methodsThis was a retrospective study conducted at Guangdong Provincial Hospital of Traditional Chinese Medicine that included patients with CHF requiring long-term renal replacement therapy between January 1, 2012 and December 31, 2017. The end of follow-up was December 31, 2020. All patients were divided into HD and PD groups and sub grouped by age, and we used univariate and multifactorial Cox regression analyses to calculate the relative hazard ratios (HR) of the different dialysis types and adjusted for differences in baseline data using propensity score matching (PSM).ResultA total of 121 patients with PD and 156 patients with HD were included in this study. Among younger ESRD patients (≤65 years of age) with CHF, the prognosis of HD was worse than that of PD [HR = 1.84, 95% confidence interval (CI) = 1.01–3.34], and this disadvantage remained significant in the fully adjusted model [sex, age at dialysis initiation, Charlson comorbidities index, body mass index, prealbumin, hemoglobin, and left ventricular ejection fraction (LVEF)] and after PSM. In the older group (>65 years of age), the prognosis of HD was better than that of PD (HR = 0.46, 95% CI = 0.25–0.85), and the protective effect remained in the fully adjusted model and after PSM. The aforementioned survival differences across the cohort were maintained in patients with preserved LVEF (>55%), but could not be reproduced in patients with reduced LVEF (≤55%).ConclusionIn southern China, PD is a better choice for younger patients with ESRD, CHF and preserved LVEF, and HD is the better option for older patients.

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“…Studies have proven its independent correlation with all-cause and cardiovascular mortality in ESRD/dialysis patients. 15,16 The issue of using LVEF in ESRD arises mainly from its dependency on loading conditions which can affect its accuracy, especially in patients undergoing dialysis, by emulating the typical clinical presentation of heart failure. Also, if the prognostic value of a low LVEF is well established, an LVEF > 45% is unable to grade risk.…”

Section: Systolic Function-left Ventricular Ejection Fraction (Lvef)mentioning

confidence: 99%

Multi‐modality cardiac imaging in advanced chronic kidney disease

Ureche

Sascău

Țăpoi³

et al. 2019

Echocardiography

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Cardiovascular disease (CVD) is the leading cause of death worldwide and is particularly frequent among those with severe renal impairment. Early diagnosis and therapeutic intervention may help alleviate the burden of cardiovascular complication within this population. In the last years, advances have been made toward developing noninvasive imaging techniques that could offer better insight into the cardiac involvement in end‐stage renal disease (ESRD). Conventional transthoracic echocardiography remains the first‐line investigation used to assess cardiac function, but encompassing in our daily practice, the newer approaches such as speckle‐tracking imaging, cardiac computed tomography, or cardiac magnetic resonance can guide us to a more comprehensive understanding of CVD in ESRD. Given that patients with chronic kidney disease may not present with typical CVD symptoms, the amount of information brought by newer imaging techniques is crucial for an accurate diagnosis, risk stratification, and further management. The purpose of this review is to briefly summarize the specific applications of standard cardiac imaging techniques in patients with ESRD and to offer insight into the novel imaging modalities, highlighting the newest research in this field. By doing so, we aim to identify the most important imaging predictors of clinical outcomes in this population.

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Association of left ventricular systolic dysfunction with mortality in incident peritoneal dialysis patients

Abstract: Reduced LVEF is significantly associated with increased all-cause and cardiovascular mortality in incident CAPD patients.

Cited by 5 publications

References 31 publications

Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis

Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis

Impact of dialysis modality choice on the survival of end-stage renal disease patients with congestive heart failure in southern China: A retrospective cohort study

Multi‐modality cardiac imaging in advanced chronic kidney disease

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