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Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation

Misato Tomura1, Yoshifumi Hamasaki2, Yohei Komaru1

  • 1Hemodialysis and Apheresis, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.

BMC Nephrology
|April 17, 2021
PubMed

Insights

Concentric left ventricular hypertrophy (cLVH) at peritoneal dialysis (PD) initiation is linked to reduced survival and major adverse cardiovascular events (MACE). Early identification of cLVH may help manage high-risk patients on PD.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Medicine

Background:

  • Concentric left ventricular hypertrophy (cLVH) is a common finding in patients on maintenance dialysis, including peritoneal dialysis (PD).
  • The prognostic significance of cLVH at the initiation of PD remains incompletely understood.
  • This study investigates the impact of cLVH on patient survival and major adverse cardiovascular events (MACE) in PD patients.

Purpose of the Study:

  • To determine the association between cLVH at PD initiation and patient survival.
  • To assess the relationship between cLVH at PD initiation and the occurrence of MACE.
  • To identify cLVH as a potential risk factor for adverse outcomes in PD patients.

Main Methods:

  • A retrospective cohort study involving 131 patients undergoing PD.
  • Echocardiography was performed at PD initiation to assess left ventricular mass index and relative wall thickness for cLVH diagnosis.
  • Cox regression analysis was used to evaluate the association between cLVH and patient prognosis.

Main Results:

  • Concentric LVH was present in 22% of patients at PD initiation.
  • Patients with cLVH exhibited significantly reduced survival, MACE-free survival, and PD continuation rates.
  • cLVH was an independent risk factor for mortality in all patients and associated with mortality and MACE in elderly patients (>65 years).
  • Lower serum albumin levels at PD initiation were correlated with cLVH.

Conclusions:

  • cLVH at PD initiation is independently associated with reduced survival in all patients and with both survival and MACE in elderly patients.
  • Assessing LV geometry at PD initiation can help identify high-risk individuals.
  • Further research with larger cohorts is needed to confirm these findings and explore interventions, such as nutritional support, to improve outcomes.
Abstract

Keywords:
Cardiovascular diseaseConcentric left ventricular hypertrophyLife prognosisPeritoneal dialysisSerum albumin

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