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Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients

  • Nephrology - Original Paper
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Abstract

Purpose

Cardiovascular disease is the leading cause of mortality in dialysis patients with left ventricular hypertrophy (LVH) being an important predictor of mortality. We wanted to determine the prevalence of LVH in peritoneal dialysis (PD) patients and factors contributing to it.

Methods

This is a cross-sectional study assessing LVH using echocardiogram in PD patients. Left ventricular mass index (LVMI) was calculated to determine LVH. Chronic fluid overload (overhydration) was assessed using the body composition monitor, and blood pressure (BP) was measured using 24-h ambulatory BP monitoring.

Results

Thirty-one patients (21 females:10 males, 48.97 ± 14.50 years and dialysis vintage 40.0 ± 28.9 months) were studied. More than two-thirds (77.4 %) were hypertensive, and a third (35.5 %) were diabetic. Baseline data included mean serum albumin (37.34 ± 4.43 g/l), weekly Kt/V (2.02 ± 0.23), residual renal function of 68 (0–880) ml and ultrafiltration of 1,606.9 ± 548.6 ml. Majority of patients (80.6 %) had LVH on echocardiogram with LVMI of 136.5 ± 37.8 g/m2 and overhydration of 2.23 ± 1.77 l. Average systolic BP, diastolic BP and mean arterial pressure were 141.2 ± 23.3, 90.8 ± 19.7 and 107.6 ± 19.6 mmHg, respectively. Patients with LVH had a lower serum albumin (p = 0.003), were more overhydrated (p = 0.010) and were on higher number of anti-hypertensive agents (p ≤ 0.001). Predictors of LVMI were overhydration (p = 0.002), the presence of diabetes (p = 0.008) and the number of anti-hypertensive agents used (p = 0.026). However, overhydration (p = 0.007) was the main predictor of LVH on multivariate analysis.

Conclusion

Overhydration is strongly associated with LVH in PD patients.

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Acknowledgments

This study received a grant from Universiti Kebangsaan Malaysia towards the cost of echocardiogram and reimbursing patients for their clinic visits. We would like to thank our three CAPD nurses for their contributions in running this study. We would also like to thank Prof NCT Kong and Associate Prof Oteh Maskon for their guidance and our Dean for allowing us to publish the findings of this study.

Conflict of interest

All authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

    Rizna Abdul Cader, Osama Ali Ibrahim, Samir Paul, Halim Abdul Gafor & Rozita Mohd

Authors
  1. Rizna Abdul Cader
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  2. Osama Ali Ibrahim
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  3. Samir Paul
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  4. Halim Abdul Gafor
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  5. Rozita Mohd
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Correspondence to Rizna Abdul Cader.

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Cader, R.A., Ibrahim, O.A., Paul, S. et al. Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients. Int Urol Nephrol 46, 1209–1215 (2014). https://doi.org/10.1007/s11255-013-0615-8

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  • DOI: https://doi.org/10.1007/s11255-013-0615-8

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