Systolic and diastolic function in renal replacement therapy: a cross-sectional study

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• Heart disease is a leading cause of mortality in patients with kidney failure.
• Assessing cardiac function is crucial for patients undergoing renal replacement therapy (RRT).

Purpose of the Study:

• To evaluate and compare left ventricular (LV) systolic and diastolic function in patients on hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (TX).

Main Methods:

• A cohort of 125 RRT patients (61 HD, 30 PD, 34 TX) were assessed over six months.
• Systolic and diastolic function indices were compared across HD, PD, and TX groups.
• Analyses were adjusted for age, gender, and duration of RRT.

Main Results:

• Hemodialysis patients exhibited poorer systolic function (lower fractional shortening and ejection fraction) compared to transplant recipients.
• Peritoneal dialysis patients demonstrated worse diastolic function than transplant recipients, with over 80% showing pathological diastolic indices.
• Hypertension prevalence was high across all groups (TX: 88.2%, PD: 86.7%, HD: 50.8%), as was left ventricular hypertrophy (LVH) (TX: 55.9%, PD: 53.3%, HD: 36.1%).

Conclusions:

• Kidney transplant recipients maintained superior systolic and diastolic cardiac function compared to both hemodialysis and peritoneal dialysis patients.
• Despite better cardiac function, transplant recipients had higher rates of hypertension and LVH, suggesting complex cardiovascular risk profiles in RRT patients.