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Kidney Week

Abstract: FR-PO398

Dialysis Modality and Cardiac Function at the Time of Kidney Pre-Transplant Patients' Evaluation

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Butros, Lawrence R., University of Kentucky, Lexington, Kentucky, United States
  • Malik, Omar, University of Kentucky, Lexington, Kentucky, United States
  • Soliman, Mohanad O., University of Kentucky, Lexington, Kentucky, United States
  • Elyamny, Mohamed, University of Kentucky, Lexington, Kentucky, United States
  • Yaseen, Maria, University of Kentucky, Lexington, Kentucky, United States
  • Elsawalhy, Eman, University of Kentucky, Lexington, Kentucky, United States
  • Viquez, Karolina, University of Kentucky, Lexington, Kentucky, United States
  • Paranzino, Marc, University of Kentucky, Lexington, Kentucky, United States
  • Suleiman, Belal, University of Kentucky, Lexington, Kentucky, United States
  • Elrefaei, Amro, University of Kentucky, Lexington, Kentucky, United States
  • Kakani, Elijah, University of Kentucky, Lexington, Kentucky, United States
  • Gedaly, Roberto, University of Kentucky, Lexington, Kentucky, United States
  • Mei, Xiaonan, University of Kentucky, Lexington, Kentucky, United States
  • Kolodziej, Andrew, University of Kentucky, Lexington, Kentucky, United States
  • Guglin, Maya, University of Kentucky, Lexington, Kentucky, United States
  • Booth, David, University of Kentucky, Lexington, Kentucky, United States
  • Mohamed, Amr El-Husseini, University of Kentucky, Lexington, Kentucky, United States
  • Castellanos, Ana L., University of Kentucky, Lexington, Kentucky, United States
  • Waid, Thomas H., University of Kentucky Medical Center, Lexington, Kentucky, United States
Background

Hemodialysis (HD), peritoneal dialysis (PD) and pre-emptive kidney transplant are different options at the time of the pre-transplant patients’ evaluation; however, it is not clear how each dialysis modality affects cardiac structure and function. This study explores the association of different dialysis modalities and the cardiac function in this patient population.

Methods

This is a single-center, retrospective and descriptive study for patients who had completed pre-transplant cardiac evaluation in the renal transplant program at University of Kentucky between January 2010 and December 2015. We classified patients into 3 groups according to the dialysis modality. Group 1 included pre-emptive patients (n=74), group 2 included PD patients (n=61), and group 3 included HD patients (n=144). We analyzed the echocardiographic parameters for all patients and correlated them with the different dialysis modalities.

Results

There were no differences in demographic parameters between the 3 groups. Pre-emptive patients had a lower rate of diabetes mellitus (p=0.046) and marginally lower coronary artery diseases (p=0.055). There was no significant difference between the three groups regarding the left ventricular ejection fraction or right ventricular systolic function as measured by end diastolic and systolic dimensions, severity of tricuspid and mitral regurgitations and diastolic function as measured by E/e’. Moreover, the pulmonary artery pressures as measured by velocity of tricuspid regurgitation and pulmonary artery acceleration time were not significantly different between groups. Left ventricular mass index was significantly higher in patients on hemodialysis and lower in patients on peritoneal dialysis (p=0.010).

Conclusion

Patients being evaluated for kidney transplantation and not yet on dialysis had lower rates of diabetes and a trend toward lower coronary artery disease compared to patients who are already on dialysis. The left ventricular mass index was the highest in HD patients and the lowest in PD patients.