The effects of dialysis-type on left ventricular function in non-diabetic end-stage renal disease patients

Abstract

Objective In this study we aimed to investigate a possible difference in left ventricular function in patients undergoing peritoneal dialysis (PD) and haemodialysis (HD) using 2D echocardiography.

Methods A total of 84 patients were recruited in the study. Both PD and HD groups consisted of 42 end-stage renal disease patients. Patients with left ventricular ejection fraction (EF) <50%, diabetes mellitus and coronary artery disease were excluded. Baseline characteristics and conventional tissue Doppler echocardiography parameters were recorded. Left ventricular longitudinal (Ls), circumferential (Cs) and radial strain (R) along with strain rate were also recorded in the speckle-tracking echocardiography. These values were compared between the two groups.

Results No significant difference was observed between PD and HD patients, in terms of mean time from diagnosis of chronic kidney disease to initiation of the study, mean time from first dialysis to initiation of the study, left ventricular EF, age, sex and heart rate. Left ventricular hypertrophy was also more frequent in HD group and the patients had a higher left ventricular mass index. Left ventricular global Ls, LSRs, LSRe, LSRa and global Rs, RSRs, RSRe, RSRa were detected to be lower in HD patients.

Conclusions Longitudinal and radial left ventricular mechanics were found to be better preserved in patients undergoing peritoneal dialysis when compared to haemodialysis patients. Consequently, it can be concluded that peritoneal dialysis provides better protection on left ventricular systolic function compared to haemodialysis.