Key result
Neutrophil-lymphocyte ratio >3.6 is linked to ~6.8-fold higher odds of LVEF <50% in peritoneal dialysis.
Why the study?
Data on factors associated with left ventricular systolic dysfunction in peritoneal dialysis patients were limited.
What clinical and laboratory factors are associated with left ventricular systolic dysfunction in patients on peritoneal dialysis?
Cross-Sectional (n=103)
No
What clinical and laboratory factors are associated with left ventricular systolic dysfunction in patients on peritoneal dialysis?
In peritoneal dialysis patients, prior coronary artery disease, diabetes, smoking, high neutrophil-to-lymphocyte ratio, and high serum phosphate are independently associated with left ventricular systolic dysfunction.
Answers are grounded in this paper and cite their sources.
Should not yet guide LVSD screening in peritoneal dialysis; leaves open prospective validation of NLR thresholds.
BACKGROUND: Factors associated with left ventricular systolic dysfunction (LVSD) of peritoneal dialysis (PD) patients are limited. We aim to explore and quantify the associated factors of LVSD among PD patients. METHODS: Participants from a PD clinic treated between 2012 and 2014 at the HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakhon Nayok, Thailand were recruited and divided into 2 groups according to their left ventricular ejection fraction (LVEF) (< 50% vs. ≥ 50%) with LVEF < 50% considered as LVSD. Correlations among the clinical, laboratory and echocardiographic variables were analyzed. The factors associated with LVSD were explored with univariate and multivariate logistic regression analyses. Beta coefficient along with odds ratio and 95% confidence interval (CI) were calculated and the P value < 0.05 was considered significant. RESULTS: Among 103 subjects stratified as LVSD (n = 18, 17.5%). The mean (SD) age was 59.3 (12.7) years, and nearly halves were males. Preexisting CAD, diabetes (DM) and current smoking were 20 (19.4%), 63 (61.2%) and 23 (22.3%) patients, respectively. The median time of dialysis vintage was 12 (3, 24) months. Factors associated with LVSD and corresponding ORs with 95% CI by multivariate analysis were prior coronary artery disease (CAD) [5.08 (1.16, 22.19)], DM [6.36 (1.29, 31.49)], smoking [10.62 (2.17, 51.99)], neutrophil to lymphocyte ratio (NLR) > 3.6 [6.77 (1.41, 32.52)], and high serum phosphate [9.39 (2.16, 40.92)] were significantly associated with LVSD. CONCLUSIONS: Prior history of CAD, DM, smoking, high NLR and serum phosphate levels were found to be associated with LVSD for our PD patients. The evidence from prospective study is needed to confirm the predictive value of these variables.
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Angkananard et al. (2019) conducted a cross-sectional in Peritoneal dialysis (n=103). Neutrophil to lymphocyte ratio (NLR) > 3.6 vs. NLR ≤ 3.6 was evaluated on Left ventricular systolic dysfunction (LVEF < 50%) (OR 6.77, 95% CI 1.41-32.52, p=0.017). A neutrophil to lymphocyte ratio greater than 3.6 was significantly associated with left ventricular systolic dysfunction (OR 6.77) in Thai patients on peritoneal dialysis.
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