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October 16, 2021BMC NephrologyOpen Access

Every 1% increase in right ventricular diameter during the first 2 years of peritoneal dialysis was associated with a 68.2% higher risk of all-cause mortality (HR 1.682).

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Why the study?

Peritoneal dialysis can be associated with abnormal cardiac structure and function and increased mortality risk, but the dynamic echocardiographic changes during the first 2 years of therapy and their links to mortality needed evaluation.

Does peritoneal dialysis affect cardiac structure and function over 2 years in patients with end-stage renal disease?

Population

72 ESRD patients starting PD

Comparison

Echocardiographic parameters at baseline vs year 1 and year 2

Design

Longitudinal cohort study

Follow-up

2 years

Key result

Every 1% increase in right ventricular diameter during the first 2 years of peritoneal dialysis was associated with a 68.2% higher risk of all-cause mortality (HR 1.682).

Authors

YZYunyun ZhuDZDifei ZhangXHXiaoxuan Hu

Discussion

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Member takes

Overview

RV enlargement on PD was associated with higher mortality; leaves open whether echocardiography-guided interventions improve survival.

Study Design

Type

Cohort (n=72)

Multicenter

No

Structured PICO

Does peritoneal dialysis affect cardiac structure and function over 2 years in patients with end-stage renal disease?

P
Population
72 adult patients (mean age 53 years, 49% female) with end-stage renal disease undergoing peritoneal dialysis, followed for 2 years with serial echocardiography.
E
Exposure
Peritoneal dialysis (PD) for 2 years with echocardiographic monitoring at baseline, year 1, and year 2.
O
Outcome
Dynamic changes in cardiac structure and function using echocardiography during the first 2 years of PD therapy, and its associations with all-cause mortality risk after 2 years of follow-up.surrogate

Main Result

Hazard Ratio: 1.682 (95% CI 1.017–2.783)

p-value: p=0.043

In patients undergoing peritoneal dialysis, right ventricular diameter significantly increases over the first 2 years, and this structural deterioration is associated with a higher risk of all-cause mortality.

Limitations

  • Single-center study
  • Retrospective, observational design
  • Small sample size
  • Short follow-up time
  • Selection bias due to only 27.3% of initial patients having complete echocardiography data
  • single-center
  • retrospective
  • observational study
  • small sample size
  • short follow-up time
  • selection bias

Cite This Study

Zhu et al. (2021) conducted a cohort in End-stage renal disease (ESRD) undergoing peritoneal dialysis (n=72). Increase in right ventricular diameter (RVD) vs. No increase or lesser increase in RVD was evaluated on All-cause mortality risk associated with echocardiographic parameter changes (HR 1.682, 95% CI 1.017-2.783, p=0.043). Every 1% increase in right ventricular diameter during the first 2 years of peritoneal dialysis was associated with a 68.2% higher risk of all-cause mortality (HR 1.682).

synapsesocial.com/papers/6a88404d7b78edf2e3608fa7https://doi.org/10.1186/s12882-021-02535-3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Nonparallel Progression of Left Ventricular Structure and Function in Long-Term Peritoneal Dialysis Patients2017 · 21 citations
  2. 2Cardiac Function and Structure in Longitudinal Analysis of Echocardiography in Peritoneal Dialysis Patients2010 · 17 citations
  3. 3Alteration of Cardiovascular Structure and Function in Patients Undergoing Peritoneal Dialysis2015 · 7 citations
  4. 4Changes in Echocardiographic Parameters According to the Rate of Residual Renal Function Decline in Incident Peritoneal Dialysis Patients2015 · 8 citations
  5. 5The effect of dialysis type on right ventricular function and patient outcomes in end-stage renal disease2025