Key result
Hemodialysis was associated with significantly lower left atrial reservoir circumferential strain (28.58% vs 34.68%) and larger left atrial volumes compared to peritoneal dialysis in patients with end-stage kidney disease.
Why the study?
Cardiovascular complications are a leading cause of mortality in end-stage kidney disease patients on dialysis, motivating an evaluation of left atrial structure and function differences between hemodialysis and peritoneal dialysis patients using 4D Auto LAQ.
Does hemodialysis compared to peritoneal dialysis affect left atrial volume and strain parameters in patients with end-stage kidney disease?
Cohort (n=125)
No
Does hemodialysis compared to peritoneal dialysis affect left atrial volume and strain parameters in patients with end-stage kidney disease?
Hemodialysis is associated with increased left atrial volume and impaired left atrial function compared to peritoneal dialysis, highlighting the utility of 4D Auto LAQ for early detection of cardiac dysfunction.
HD patients show larger LA volumes and lower strain than PD; leaves open whether modality influences outcomes or requires targeted monitoring.
Background Cardiovascular complications remain a leading cause of mortality in patients with end-stage kidney disease undergoing dialysis. This study aimed to evaluate differences in left atrial (LA) structure and function between hemodialysis and peritoneal dialysis patients using four-dimensional automatic left atrial quantification (4D Auto LAQ) technology.Methods This study included 125 patients with end-stage kidney disease, categorized into hemodialysis (n = 69) and peritoneal dialysis (n = 56) groups. Conventional echocardiography and 4D Auto LAQ were used to assess LA volume and strain parameters. Differences between groups were analyzed.Results Hemodialysis patients exhibited significantly larger LA minimum volume, maximum volume, pre-atrial contraction volume, and maximum volume index compared to peritoneal dialysis patients (p < 0.05). Conversely, hemodialysis patients had significantly lower LA reservoir circumferential strain (LASr-c) and conduit circumferential strain (LAScd-c) than peritoneal dialysis patients (p < 0.05). LA ejection fraction (LAEF) correlated positively with LASr-c (r = 0.809). Multivariate regression analysis identified LASr-c as independently associated with dialysis modality and LAEF. Sensitivity analysis confirmed LAEF as an independent determinant of LASr-c.Conclusions Hemodialysis is associated with increased LA volume and impaired LA function compared to peritoneal dialysis. These findings highlight the importance of LA monitoring in dialysis patients to identify early cardiac dysfunction.
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Ma et al. (2025) conducted a cohort in End-stage kidney disease (n=125). Hemodialysis vs. Peritoneal dialysis was evaluated on Left atrial reservoir circumferential strain (LASr-c) (p=0.001). Hemodialysis was associated with significantly lower left atrial reservoir circumferential strain (28.58% vs 34.68%) and larger left atrial volumes compared to peritoneal dialysis in patients with end-stage kidney disease.
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