Rio de La Plata study: A multicenter, cross-sectional study on cardiovascular risk factors and heart failure prevalence in peritoneal dialysis patients in Argentina and Uruguay

Abstract

A multicenter cross-sectional study was performed to evaluate the prevalence of heart failure (HF) and the associated cardiovascular (CV) risk factors in 298 peritoneal dialysis (PD) patients from Argentina and Uruguay, representing almost 30% of the total number of PD patients in the two countries. Bidimensional echocardiography, electrocardiography, and biochemical analysis were performed. Systolic HF was defined as an ejection fraction <50%. According to echocardiography, 84.6% showed left ventricular hypertrophy (LVH), 38.3% valvular heart disease, and 35.4% valvular calcification, whereas 20% showed intraventricular conduction disturbances on the electrocardiogram. The prevalence of CV risk factors was of 73% hypertension, 51% sedentarism, 18% diabetes, 16.8% obesity, 12% smokers, 42.3% phosphorus >5.5 mg per 100 ml, 42.3% parathyroid hormone>300 pg ml(-1), and 29.6% calcium phosphate product >55. The prevalence of systolic HF was 9.9%, being significantly associated with diabetes: odds ratio (OR)=4.11 (P<0.006) and hypoalbuminemia: OR=3.45 (P<0.011). Forty percent of patients with a diagnosis of left ventricular dysfunction at the time of the study were asymptomatic. Variables associated with LVH in the multivariate analysis were anemia (OR=4.06; P<0.001) and previous hemodialysis (OR=1.99; P<0.031). The identification of reversible risk factors associated to HF and the diagnosis of asymptomatic ventricular dysfunction in this PD population will lead our efforts to establish guidelines for prevention and early treatment of congestive HF in patients on PD.

Family Income and Survival in Brazilian Peritoneal Dialysis Multicenter Study Patients (BRAZPD)

“…Brazil is a country of continental dimensions, with large ethnic, geographic, and cultural diversity, and with substantial social and regional inequalities (3,10). Brazilian PD patients have social characteristics similar to the ones described in other studies performed in Latin America that point to a low ES in this population group (7,17,25). These factors make the results of this study fairly representative, at least for the Latin American countries.…”

“…These factors make the results of this study fairly representative, at least for the Latin American countries. Indeed, Moretta et al (25) have recently reported the results of a multicenter cross-sectional study performed in a population representing almost 30% of the PD patients in Argentina and Uruguay. Regarding socioeconomic status, 44% of all patients were under the poverty line, and 25% of all patients were required to start on PD because there was no other RRT option available (25).…”

Cardiothoracic Ratio Association With Mortality in Patients on Maintenance Peritoneal Dialysis

“…Moretta et al. reported that anemia was significantly associated with LVH in PD patients (12). Further, Toprak et al.…”

The cardio-renal-anaemia syndrome predicts survival in peritoneally dialyzed patients

“…In a recent study from Latin America on 298 prevalent PD patients, systolic heart failure was strongly associated with diabetes and hypoalbuminaemia [28], factors we found to be strong predictors of mortality. In addition, anaemia was associated significantly with left ventricular hypertrophy.…”