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High-density lipoprotein cholesterol and left ventricular mass index in peritoneal dialysis
Ryota Ikee1, Yoshifumi Hamasaki, Machiko Oka
1Department of Nephrology, Shonan Kamakura General Hospital, Kanagawa, Japan. ryota.ikee@tokushukai.jp
Insights
Left ventricular hypertrophy (LVH) is common in peritoneal dialysis (PD) patients. This study found that human atrial natriuretic peptide (hANP) and high-density lipoprotein cholesterol (HDL-C) are independently associated with LVH in PD patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Left ventricular hypertrophy (LVH) affects up to 75% of patients with end-stage renal disease.
- Factors like hypertension and volume overload are known contributors to LVH in peritoneal dialysis (PD) patients.
- The relationship between dyslipidemia and LVH in PD patients is not well-established.
Purpose of the Study:
- To investigate the association between clinical parameters, including lipid profiles, and left ventricular mass index (LVMI) in PD patients.
- To identify potential risk factors for LVH in patients undergoing long-term PD.
Main Methods:
- A cross-sectional study included 34 patients on PD for over one year.
- Echocardiography was used to evaluate LVMI.
- Clinical data, including lipid profiles and urine volume, were collected and analyzed.
Main Results:
- Mean LVMI was 142 ± 37 g/m².
- Univariate analysis revealed significant correlations between LVMI and urine volume, total cholesterol, HDL-C, and hANP.
- Stepwise multiple regression identified hANP and HDL-C as independent predictors of LVMI (r² = 0.32).
Conclusions:
- Strict volume control and salt restriction are crucial for preventing LVH in PD patients.
- The specific role of HDL-C in the development of LVH among PD patients warrants further investigation.
Objective:
The prevalence of left ventricular hypertrophy (LVH) reaches 75% in patients with end-stage renal disease. In patients on peritoneal dialysis (PD), some factors, such as hypertension, volume overload, serum albumin, and residual renal function, have been reported to be related to LVH. Dyslipidemia often occurs in PD but it remains unclear whether dyslipidemia is related to LVH. We investigated the relationship between clinical parameters, including lipid profile, and left ventricular mass index (LVMI).
Methods:
In this cross-sectional study, 34 patients undergoing PD for more than 1 year without combined therapy with hemodialysis were included. We recorded the patients' clinical data and related those parameters with LVMI as evaluated by echocardiography.
Results:
The patients included 23 males and 11 females (age 62.2 +/- 12.1 years, duration on PD 31.6 +/- 15.6 months). Mean LVMI was 142 +/- 37 g/m2. In univariate analysis, urine volume (r = -0.493, p = 0.003), total cholesterol (r = -0.418, p = 0.01), high-density lipoprotein cholesterol (HDL-C; r = -0.374, p = 0.02), and human atrial natriuretic peptide (hANP; r = 0.600, p < 0.001) significantly correlated with LVMI. Stepwise multiple regression analysis showed that hANP (beta = 0.524, p = 0.001) and HDL-C (beta = -0.422, p = 0.007) were independently associated with LVMI (r2 = 0.32).
Conclusion:
Strict volume control and salt restriction is essential for prevention of LVH. The role of HDL-C in the development of LVH in PD patients remains to be determined.
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