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

TitleA novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients
Authors
Issue Date2002
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
Citation
Kidney International, 2002, v. 62 n. 2, p. 639-647 How to Cite?
AbstractBackground. Left ventricular hypertrophy (LVH) and dialysis adequacy are both important predictors for mortality in dialysis patients. This study evaluated the association between residual renal function (RRF) and the severity of LVH in end-stage renal failure (ESRF) patients undergoing long-term continuous ambulatory peritoneal dialysis (CAPD). Methods. A cross-section study was performed with left ventricular mass index (LVMi), determined in 158 non-diabetic CAPD patients using echocardiography and its relationship with residual glomerular filtration rate (GFR), peritoneal dialysis (PD) and total weekly urea clearance (Kt/V) and other known risk factors for LVH was evaluated. Results. Twelve patients had no LVH (group I). The remaining 146 patients were stratified [group II (lowest), III and IV (highest)] according to the LVMi (median 207 g/m2; range 103 to 512 g/m2). Across the four groups of patients with increasing LVMi, there was significant decline in GFR (2.27 ± 1.98 vs. 1.49 ± 1.58 vs. 1.61 ± 1.91 vs. 0.80 ± 1.42 mL/min/1.73 m2; P = 0.011) and total weekly Kt/V (1.98 ± 0.44 vs. 1.96 ± 0.38 vs. 1.92 ± 0.42 vs. 1.71 ± 0.42; P = 0.037); however, PD Kt/V was similar for all four groups. Patients with better-preserved residual GFR not only had significantly higher total Kt/V, but were less anemic and hypoalbuminemic and had a trend toward lower systolic blood pressure and arterial pulse pressure. Multiple regression analysis showed that other than age, gender, body weight, arterial pulse pressure, hemoglobin and serum albumin, known factors for LVH, residual GFR (estimated mean -7.94; 95% confidence interval -15.13 to -0.74; P = 0.031) was also independently associated with LVMi. Conclusions. Other than anemia, hypoalbuminemia and arterial pulse pressure, this study demonstrates an important, novel association between the degree of RRF and severity of LVH in ESRF patients undergoing long-term CAPD. Prospective studies are needed to define if indeed there is a cause-effect relationship between this association, to evaluate if a decline in residual GFR is independently associated with an increase in LVMi, and to determine whether treatment directed at preserving RRF will reduce the severity of LVH, improve cardiac performance and hence survival of these patients.
Persistent Identifierhttp://hdl.handle.net/10722/162565
ISSN
2015 Impact Factor: 7.683
2015 SCImago Journal Rankings: 3.181
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorLaw, MCen_US
dc.contributor.authorChow, KMen_US
dc.contributor.authorLi, PKTen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorSanderson, JEen_US
dc.date.accessioned2012-09-05T05:21:14Z-
dc.date.available2012-09-05T05:21:14Z-
dc.date.issued2002en_US
dc.identifier.citationKidney International, 2002, v. 62 n. 2, p. 639-647en_US
dc.identifier.issn0085-2538en_US
dc.identifier.urihttp://hdl.handle.net/10722/162565-
dc.description.abstractBackground. Left ventricular hypertrophy (LVH) and dialysis adequacy are both important predictors for mortality in dialysis patients. This study evaluated the association between residual renal function (RRF) and the severity of LVH in end-stage renal failure (ESRF) patients undergoing long-term continuous ambulatory peritoneal dialysis (CAPD). Methods. A cross-section study was performed with left ventricular mass index (LVMi), determined in 158 non-diabetic CAPD patients using echocardiography and its relationship with residual glomerular filtration rate (GFR), peritoneal dialysis (PD) and total weekly urea clearance (Kt/V) and other known risk factors for LVH was evaluated. Results. Twelve patients had no LVH (group I). The remaining 146 patients were stratified [group II (lowest), III and IV (highest)] according to the LVMi (median 207 g/m2; range 103 to 512 g/m2). Across the four groups of patients with increasing LVMi, there was significant decline in GFR (2.27 ± 1.98 vs. 1.49 ± 1.58 vs. 1.61 ± 1.91 vs. 0.80 ± 1.42 mL/min/1.73 m2; P = 0.011) and total weekly Kt/V (1.98 ± 0.44 vs. 1.96 ± 0.38 vs. 1.92 ± 0.42 vs. 1.71 ± 0.42; P = 0.037); however, PD Kt/V was similar for all four groups. Patients with better-preserved residual GFR not only had significantly higher total Kt/V, but were less anemic and hypoalbuminemic and had a trend toward lower systolic blood pressure and arterial pulse pressure. Multiple regression analysis showed that other than age, gender, body weight, arterial pulse pressure, hemoglobin and serum albumin, known factors for LVH, residual GFR (estimated mean -7.94; 95% confidence interval -15.13 to -0.74; P = 0.031) was also independently associated with LVMi. Conclusions. Other than anemia, hypoalbuminemia and arterial pulse pressure, this study demonstrates an important, novel association between the degree of RRF and severity of LVH in ESRF patients undergoing long-term CAPD. Prospective studies are needed to define if indeed there is a cause-effect relationship between this association, to evaluate if a decline in residual GFR is independently associated with an increase in LVMi, and to determine whether treatment directed at preserving RRF will reduce the severity of LVH, improve cardiac performance and hence survival of these patients.en_US
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.htmlen_US
dc.relation.ispartofKidney Internationalen_US
dc.titleA novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patientsen_US
dc.typeArticleen_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1523-1755.2002.00471.xen_US
dc.identifier.pmid12110029-
dc.identifier.scopuseid_2-s2.0-0035991581en_US
dc.identifier.volume62en_US
dc.identifier.issue2en_US
dc.identifier.spage639en_US
dc.identifier.epage647en_US
dc.identifier.isiWOS:000176746600033-
dc.publisher.placeUnited Kingdomen_US

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