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Hemodialysis versus continuous ambulatory peritoneal dialysis: effects on the heart
M E Canziani1, M Cendoroglo Neto, M A Saragoça
1Nephrology Division of Escola Paulista de Medicina and Centrocor, São Paulo, Brazil.
Insights
Continuous Ambulatory Peritoneal Dialysis (CAPD) is associated with lower rates of hypertension, left ventricular hypertrophy (LVH), and cardiac arrhythmias compared to hemodialysis in chronic renal failure patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic renal failure (CRF) patients often develop cardiovascular complications.
- Left ventricular hypertrophy (LVH) and cardiac arrhythmias are significant concerns in CRF.
- Treatment modality may influence cardiovascular outcomes in CRF.
Purpose of the Study:
- To compare the effects of Continuous Ambulatory Peritoneal Dialysis (CAPD) and hemodialysis on LVH and cardiac arrhythmias.
- To assess the prevalence and severity of cardiovascular issues in patients undergoing different dialysis treatments.
Main Methods:
- A comparative study involving 54 CRF patients (27 on CAPD, 27 on hemodialysis).
- Patients were matched for sex, age, and dialysis duration.
- Evaluated hypertension, blood pressure, LVH, and cardiac arrhythmias (Lown classification).
Main Results:
- CAPD patients had significantly lower hypertension prevalence (41% vs. 81%) and blood pressure levels.
- LVH was less frequent in CAPD patients (52% vs. 93%).
- Severe cardiac arrhythmias (Lown 3-4) were significantly lower in CAPD patients (4% vs. 33%).
Conclusions:
- CAPD demonstrates a lower prevalence and severity of hypertension, LVH, and cardiac arrhythmias compared to hemodialysis.
- Reduced LVH in CAPD may contribute to a lower incidence of severe arrhythmias.
- Treatment modality choice is crucial for managing cardiovascular health in CRF patients.
Abstract:
In this study we compared the influence of 2 different modalities of treatment, CAPD and hemodialysis, on the prevalence and severity of left ventricular hypertrophy and cardiac arrhythmias of chronic renal failure patients. We compared 27 patients on the CAPD program with 27 patients on the chronic hemodialysis matched for sex, age, and duration of dialysis treatment. The prevalence of hypertension was significantly lower in CAPD than in hemodialysis patient (41% vs. 81%, p = 0.0023). Blood pressure levels were also lower in CAPD than in hemodialysis patients (systolic pressure 124.9 +/- 4.7 vs. 154.8 +/- 4.6 mm Hg, p < 0.0001; diastolic pressure 77.5 +/- 2.9 vs. 93.3 +/- 2.8 mm Hg, p = 0.0001). Left ventricular hypertrophy (LVH) was present in 52% of CAPD and in 93% of hemodialysis patients (p = 0.0008). Severe cardiac arrhythmias (Lown 3-4) occurred in only 4% of CAPD and in 33% of the hemodialysis group (p = 0.0149). The lower frequency of LVH in CAPD might explain the lower incidence of severe arrhythmias.