Abstract: PO1005
Progression of Left Ventricular Mass Index After Peritoneal Dialysis Initiation: A Potential Killer
Session Information
- Peritoneal Dialysis
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chen, Yun, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Dai, Shuqi, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Hao, Chuan-Ming, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Zhu, Tongying, Huashan Hospital Fudan University, Shanghai, Shanghai, China
Background
Left ventricular hypertrophy (LVH), defined by the left ventricular mass index (LVMI), is highly prevalent in dialysis patients. LVMI has been widely accepted as a strong predictor of cardiovascular events. However, the dynamic changes of LVMI are rarely discussed, especially among peritoneal dialysis (PD) patients. The study aimed to investigate the prognostic significance of LVMI-progression in PD patients, and explore risks factors for LVMI-progression.
Methods
It was designed as a prospective, observational study. Incident PD patients between February 2008 and July 2018 were recruited. Echocardiography was performed yearly to collect LVMI and evaluate its progression. Participants were divided into two subgroups: group with LVMI-progression and group without LVMI-progression. The end points include all-cause mortality, cardiovascular mortality and cardiovascular events. Cox regression models were performed to identify the associations between LVMI-progression and these endpoints. Multivariate logistic regression was conducted to identify factors associated with LVMI-progression.
Results
A total of 216 PD patients (130 men,60.2%) with a mean age of 54.3±16.7 years were recruited. LVMI-progression was identified in 65 patients (30%) after PD initiation. The cohort was followed for a median duration of 65.9 months. Multivariable Cox regression analysis revealed that LVMI-progression was an independent predictor of all-cause mortality (HR, 2.111; 95%CI, 1.148–3.881; p = 0.016), cardiovascular mortality (HR, 2.785; 95%CI, 1.151–6.741; p = 0.023), and cardiovascular events (HR, 1.869; 95% CI, 1.016–3.439; p = 0.044). Multivariable logistic regression showed that hemoglobin (OR, 0.967; 95% CI, 0.939–0.996; p = 0.027), ferritin (OR, 0.995; 95% CI, 0.992–0.999; p = 0.007) and mean arterial pressure (MAP) (OR, 1.048; 95% CI, 1.001–1.097; p = 0.043) were significantly associated with LVMI-progression.
Conclusion
LVMI-progression after PD initiation was independently associated with all-cause mortality and cardiovascular outcomes in PD patients. The dynamic monitoring of LVMI might therefore help identify high-risk patients early. Further studies are needed to clarify whether treatment interventions for factors such as anemia could improve patient outcomes.