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

Area of Science:

• Nephrology
• Cardiology
• Clinical Medicine

Background:

• Cardiovascular disease (CVD) is a major cause of death in patients undergoing peritoneal dialysis (PD).
• The prognostic value of left ventricular ejection fraction (LVEF) in this population remains unclear.
• Understanding LVEF's impact is crucial for managing PD patients at risk of CVD.

Purpose of the Study:

• To investigate the association between LVEF and mortality in patients initiating continuous ambulatory peritoneal dialysis (CAPD).
• To determine if LVEF predicts all-cause and cardiovascular mortality in incident CAPD patients.

Main Methods:

• A cohort of 594 incident CAPD patients was analyzed.
• Patients were stratified into three groups based on LVEF: >0.6, 0.5–0.6, and <0.5.
• Kaplan-Meier analysis and Cox proportional hazards models were employed to assess LVEF's impact on mortality.

Main Results:

• Lower LVEF (<0.5) was associated with significantly worse overall survival and cardiovascular death-free survival.
• Patients with LVEF 0.5–0.6 and <0.5 had increased adjusted all-cause mortality hazard ratios of 1.62 and 1.93, respectively, compared to LVEF >0.6.
• Adjusted cardiovascular mortality hazard ratios were 1.60 and 2.16 for LVEF 0.5–0.6 and <0.5, respectively.

Conclusions:

• Reduced LVEF is a significant independent predictor of increased all-cause mortality in incident CAPD patients.
• Lower LVEF is also significantly associated with a higher risk of cardiovascular mortality in this patient group.
• These findings highlight the importance of assessing LVEF for risk stratification and management in PD patients.