Kidney Week

Abstract: FR-PO349

Impact of Hybrid Therapy with Peritoneal Dialysis and Hemodialysis on Cardiac Events

Session Information

• Hypertension and CVD: Clinical, Outcomes, Trials
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

• Banshodani, Masataka, Tsuchiya General Hospital, Hiroshima, Japan

Masataka Banshodani,

• Moriishi, Misaki, Tsuchiya General Hospital, Hiroshima, Japan

Misaki Moriishi,

• Shintaku, Sadanori, Tsuchiya General Hospital, Hiroshima, Japan

Sadanori Shintaku,

• Tsuchiya, Shinichiro, Tsuchiya General Hospital, Hiroshima, Japan

Shinichiro Tsuchiya,

• Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan

Hideki Kawanishi,

Background

The impact of hybrid therapy with peritoneal dialysis (PD) and hemodialysis on cardiac events in PD patients remains unclear.

Methods

PD patients, who underwent the hybrid therapy for at least 3 years, were divided into low cardiac function (LCF, left ventricular ejection fraction [LVEF] < 60%) and normal cardiac function (NCF, LVEF ≥ 60%) groups by cardiac function at the initiation of the hybrid therapy. In these patients, emergency hospitalization rate for cardiovascular diseases (CVDs) (hospitalizations/patient-dialysis years) and echocardiographic parameters (mean ± standard deviation) were evaluated.

Results

The mean age and PD vintage at the initiation of the hybrid therapy in both groups were the followings: LCF group (n = 29), 57.0 ± 11.8 and 3.6 ± 3.3 years; NCF group (n = 64), 58.0 ± 10.8 (P = 0.7) and 4.5 ± 3.2 (P = 0.2) years. The 1-year emergency hospitalization rate for CVDs significantly decreased after the initiation of the hybrid therapy in both groups: LCF group, 0.36 to 0.11 (P = 0.02); NCF group, 0.45 to 0.09 (P < 0.001). In longitudinal analyses for 3 years after the initiation of the hybrid therapy using generalized linear mixed models, in LCF group, LVEF (44.1 ± 15.0%) significantly improved 1 (53.2 ± 18.2%), 2 (55.5 ± 16.7%), and 3 (57.7 ± 17.0%) years after the initiation (every P < 0.05), whereas, in NCF group, LVEF (68.4 ± 5.5%) was maintained at the same level 1 (67.1 ± 7.9%), 2 (66.9 ± 8.7%), and 3 (68.1 ± 9.0%) years after the initiation (every P > 0.05). Moreover, in LCF group, LV mass index (LVMI) (189.1 ± 41.2 g/m²) decreased 1 (177.7 ± 35.3 g/m², P = 0.8), 2 (159.5 ± 44.8 g/m², P = 0.008), and 3 (166.4 ± 46.8 g/m², P = 0.05) years after the initiation, whereas, in NCF group, LVMI (156.8 ± 44.7 g/m²) was maintained at the same level 1 (152.8 ± 40.4 g/m²), 2 (154.6 ± 54.4 g/m²), and 3 (158.5 ± 52.2 g/m²) years after the initiation (every P > 0.05).

Conclusion

The hybrid therapy may decrease CVDs and improve cardiac function in PD patients with LCF.