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Abstract: TH-PO417

Concentric Left Ventricular Hypertrophy at Peritoneal Dialysis Initiation May Predict Death and Cardiovascular Disease in Patients Using Neutral-pH Solution

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Hamasaki, Yoshifumi, The University of Tokyo Hospital, Tokyo, Japan
  • Yoshida, Teruhiko, The University of Tokyo, Tokyo, Japan
  • Matsumoto, Akihiko, The University of Tokyo Hospital, Tokyo, Japan
  • Isshiki, Rei, The University of Tokyo Hospital, Tokyo, Japan
  • Noiri, Eisei, The University of Tokyo, Tokyo, Japan
  • Nangaku, Masaomi, The University of Tokyo, Tokyo, Japan
Background

Left ventricular hypertrophy (LVH) is known as one of the risk factors of mortality and cardiovascular disease (CVD) in the patients undergoing peritoneal dialysis (PD). Concentric LVH (cLVH) is the most frequent left ventricular geometry model in dialysis patients. The relationship between cLVH at PD initiation and prognosis is not well known. We investigated whether cLVH at PD initiation is associated with mortality and incidence of CVD in PD patients.

Methods

The data from patients who started PD at The University of Tokyo Hospital were collected retrospectively. Clinical parameters measured at PD initiation were obtained. The definition of cLVH was as follows; left ventricular mass index is ≧115 g/m2 and relative wall thickness is ≧0.42. All patients were divided into two groups with and without cLVH. Morality, incidence of CVD, technique survival rate were compared between two groups. We also investigated the relationship between clinical parameters and cLVH at PD initiation.

Results

A total of 126 patients was included and mean follow-up period was 44 months. The mean age was 58.5±11.8 y.o., male was 76%, and automated PD was selected in more than 90% patients. All patients were treated using neutral-pH PD solution. Twenty-six patients (21%) had cLVH at PD initiation. Kaplan-Meier analysis revealed that cLVH group had significant higher mortality, higher incidence of CVD, and lower technique survival rate compared with non-cLVH group (Log rank: p < 0.01, = 0.02, and < 0.01, respectively). The result of Cox proportional hazards model demonstrated that age and cLVH were independent predictors of mortality (hazard ratio, 1.08 and 3.67; 95%CI, 1.04 to 1.14 and 1.18 to 11.46; p < 0.01 and = 0.02; respectively). Age, hemoglobin, and geriatric nutrition risk index (GNRI) were independently correlated with cLVH (odds ratio [95% confidence interval]: 1.07 [1.02-1.11], 0.53 [0.30-0.93], and 0.92 [0.86-0.99], respectively).

Conclusion

Concentric LVH at PD initiation may be a possible predictor of mortality and CVD in patients using neutral-pH PD solution.