Abstract: TH-PO862

Left Ventricular Mass Index at Peritoneal Dialysis Initiation Is Possible Risk of Cardiovascular Disease and Death in Peritoneal Dialysis Patients Using Biocompatible Solution

Session Information

  • Peritoneal Dialysis - I
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Hamasaki, Yoshifumi, The University of Tokyo, Tokyo, Japan
  • Yoshida, Teruhiko, The University of Tokyo, Tokyo, Japan
  • Matsuura, Ryo, The University of Tokyo, Tokyo, Japan
  • Doi, Kent, The University of Tokyo, Tokyo, Japan
  • Noiri, Eisei, The University of Tokyo, Tokyo, Japan
  • Nangaku, Masaomi, The University of Tokyo, Tokyo, Japan
Background

Left ventricular hypertrophy (LVH) is recognized as a predictor of cardiovascular disease (CVD) and risk of mortality in patients undergoing maintenance peritoneal dialysis (PD). It is not well known whether LVH at PD initiation is associated with the mortality or CVD in patients even when they are treated using biocompatible PD solution (BPDS). We investigated the relationship between clinical parameters including left ventricular mass index (LVMI) at PD initiation and prognosis of patients using BPDS.

Methods

The data from patients who started PD from 2001 to 2015 at The University of Tokyo Hospital were collected retrospectively. To identify the predictors of death and major cardiovascular adverse event (MACE), we analyzed data including clinical parameters measured within 6 months after starting PD using BPDS. LVMI was also evaluated using the data of echocardiography performed at the same period. MACE is defined as cardiovascular death or CVD (cerebrovascular disease, ischemic heart disease or heart failure, and peripheral arterial disease), occurred until April 2017.

Results

121 patients who started PD as their first dialysis modality were included. The mortality rate was 10.7% (13/121), and MACE were occurred in 31 patients. Logistic regression analysis found that LVMI and age were independent risk factors of mortality (odds ratio, 1.04 and 1.19; 95% confidence interval (CI), 1.01 to 1.07 and 1.08 to 1.32; p <0.01 and p <0.01; respectively). When patients were divided into two groups according to LVMI, Kaplan-Meier analysis revealed that higher LVMI group had significant higher mortality, higher incidence of MACE, and lower persistence rate of PD (Log rank: p = 0.003, 0.005 and 0.011, respectively). On ROC analysis, LVMI predicted mortality with statistical significance (AUC [95%CI] =0.87 [0.76-0.98]). The result of Cox proportional hazards model on mortality demonstrated that LVMI and age were independent predictor of mortality (hazard ration, 1.02 and 1.08; 95%CI, 1.00 to 1.05 and 1.02 to 1.15; p = 0.02 and <0.01; respectively).

Conclusion

LVMI at PD initiation may be a predictor of mortality and CVD in patients using BPDS.