Associations of left ventricular systolic dysfunction with the factors among Thai patients on peritoneal dialysis: a cross-sectional study.

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.

Echocardiographic and Clinical Characteristics Cross-Sectional Study in Association with Thai Peritoneal Dialysis Patients: Data from a Single Center Study.

BACKGROUND: The dialysis patients have a lot of changes in cardiac structure and function detected by echocardiography and they have been recognized as key outcome predictors. However, the available data regarding echocardiographic alterations in Thai Continuous Ambulatory Peritoneal Dialysis (CAPD) patients is limited. This study aimed to determine the correlation between baseline clinical and echocardiographic characteristics of Thai CAPD patients. MATERIAL AND METHOD: This study was a single center and cross-sectional observational study, which enrolled all CAPD outpatients (104 patients), treated at Srinakharinwirot Medical University between 1 September 2012 and 31 June, 2014. Their demographic and echocardiographic data were collected one time and the latest laboratory data to the patient's echocardiographic study date were analyzed. RESULTS: One hundred and four patients (50 men and 54 women) whose mean age was 59.4 ± 12.7 years and median duration of CAPD was 12 months were recruited. An extremely high prevalence of elevated left ventricular mass index (LVMI), 82.7% was found which mean LVMI was higher in male than female (166.2 ± 55.6 vs. 131 ± 47.6 g/m2). All patients had diastolic dysfunction and most ofthem had diastolic dysfunction grade I. The studyfactors of male gender, history of hypertension, high serum phosphate, low hemoglobin level, corrected QT interval, and duration of CAPD longer than 24 months can predict the variation of LVMI. Interestingly, the study found that a duration of CAPD of longer than 42 months might reduce right ventricular systolic pressure. CONCLUSION: This study revealed a higher prevalence of left ventricular hypertrophy (LVH) in Thai CAPD patients when compared with previous studies and anemia still be an important independentfactor for developing LVH. Longer period of CAPD may regress LVH and lower RVSP that should be proven by longer well-designed prospective studies.