Abstract: FR-PO0536
Index of Left Ventricular Diastolic Dysfunction Early After Peritoneal Dialysis Initiation May Be Associated with Patient and Technique Survival
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Author
- Hamasaki, Yoshifumi, Tokyo Daigaku Igakubu Fuzoku Byoin Ketsueki Joka Ryohobu, Bunkyo, Tokyo, Japan
Background
Left ventricular diastolic dysfunction (LVDD) is an early cardiac function change associated with cardiovascular complications and poor prognosis in patients with kidney disease. It has been reported that E/e', a marker of LVDD, is associated with mortality and cardiovascular events in maintenance dialysis patients. We investigated the association between E/e' assessed early after peritoneal dialysis (PD) initiation and adverse outcomes.
Methods
This retrospective observational study included patients who started PD from 2009 to 2023 at our hospital. The septal and lateral E/e’ ratios obtained from transthoracic echocardiography performed within 6 months after PD initiation were used to calculate their mean value (E/e' ave). The relationship between E/e' ave and outcomes, death and PD withdrawal (transition to hemodialysis), was evaluated.
Results
This study included 75 incident PD patients with a median age of 64.6 years. The median time from PD initiation to echocardiography examination was 3.3 months. When patients were divided into two groups based on the median E/e' ave of 9.4, results from Kaplan-Meier analysis showed that the higher E/e’ ave group had a significantly higher mortality and PD discontinuation rate than the lower E/e’ ave group (log rank, p < .001). Cox proportional hazards models demonstrated that E/e' ave greater than 9.4 may be an independent risk factor for death or PD discontinuation (HR [95%CI] = 2.79 [1.25–6.18]). There were significant positive correlations between E/e' ave and age, BNP, and D/P Cr (correlation coefficients are 0.31, 0.36, and 0.26, respectively), and negative correlation between E/e’ ave and serum creatinine (correlation coefficients was -0.36). The value of E/e’ ave was significantly higher in the patient group with diabetes and left ventricular hypertrophy than that without them.
Conclusion
Higher E/e' ratio early after PD initiation might be associated with death and PD withdrawal, possibly suggesting an association between impaired LVDD and poor outcome.