Key result
Long-term CAPD linked to ~90-fold higher odds of diastolic dysfunction versus HD.
Why the study?
HD and CAPD affect left ventricular hemodynamics, motivating a comparison of their effects on left ventricular systolic and diastolic functions in maintenance dialysis patients.
Does continuous ambulatory peritoneal dialysis compared to hemodialysis worsen left ventricular functions and geometry in long-term dialysis patients?
Cohort (n=47)
Echocardiographers blinded
No
Does continuous ambulatory peritoneal dialysis compared to hemodialysis worsen left ventricular functions and geometry in long-term dialysis patients?
Effect estimate: OR 90.48 (95% CI 3.75-2180.57)
Absolute Event Rate: 66.7% vs 26.1%
p-value: p=0.006
Long-term continuous ambulatory peritoneal dialysis is associated with significantly higher rates of left ventricular hypertrophy and diastolic dysfunction compared to hemodialysis.
May warrant enhanced diastolic monitoring in long-term CAPD; leaves open causal effects versus confounding.
Background: Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) affect left ventricular hemodynamics. This study compared the effect of two treatment modalities, CAPD and HD, on left ventricular systolic and diastolic functions in maintenance dialysis patients. Methods: A total of 47 patients (24 CAPD and 23 HD) undergoing long-term dialysis were included in the study. Left ventricular functions, left ventricular hypertrophy, and left ventricular geometry were evaluated using echocardiography. Results: The mean age of the patients was 58.6 ± 11.2 years. The mean dialysis time was 125.1 ± 35.2 months. When echocardiographic parameters were examined, left ventricular muscle mass, mass index, E/e’ ratios, and global longitudinal strain were significantly higher in the CAPD group. The rates of diastolic dysfunction (66.7% vs. 26.1%) and left ventricular hypertrophy (91.7% vs. 60.9%) were higher in the CAPD group than in the HD group. Dialysis modality CAPD, abnormal global longitudinal strain (GLS), and increased serum calcium were associated with an increased risk of diastolic dysfunction. Conclusions: The study results demonstrated that left ventricle (LV) diastolic dysfunction and deterioration in left ventricular geometry were significantly higher in patients receiving long-term CAPD treatment than for long-term HD treatment.
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Usta et al. (2024) conducted a cohort in End-stage kidney disease on long-term dialysis (n=47). Continuous ambulatory peritoneal dialysis (CAPD) vs. Hemodialysis (HD) was evaluated on Diastolic dysfunction (OR 90.48, 95% CI 3.75-2180.57, p=0.006). Long-term continuous ambulatory peritoneal dialysis was associated with a significantly higher risk of diastolic dysfunction compared to hemodialysis (OR 90.48).
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