Objectives To investigate the incidence and risk factors of abnormal left ventricular diastolic
function in maintenance peritoneal dialysis (PD) patients with normal ejection fractions. Methods This study
was a cross-sectional survey. Echocardiography data as well as clinical and laboratory data of the maintenance
PD patients who came to Ruijin Hospital affiliated to Shanghai Jiao Tong University for follow-up between
November 2020 and March 2021 were collected. PD patients with left ventricular ejection fraction ＞50%
were enrolled for the screening study. Echocardiographic parameters, clinical and laboratory data were compared between patients with abnormal left ventricular diastolic function and control patients. Binary logistic regression was used to analyze the risk factors for abnormal left ventricular diastolic function in the PD patients
with normal ejection fraction. Results A total of 103 patients were enrolled in the study. Abnormal left ventricular diastolic function (E/e’＞14) was found in 31 patients. In the PD patients with abnormal left ventricular diastolic function, fractional urea clearance (Kt/V) [median 2.0 (1.7, 2.3) vs. 2.1(1.9, 2.6), U=1406.000,
P=0.037] and qualified blood pressure rate (29.0% vs. 51.4%, c2=4.382, P=0.036) were lower, and N-terminal
pro b- type natriuretic peptide (NT- proBNP) [median 12131.0 (5242.0, 30883.0)pg/ml vs. 2981 (940.4,
14665.0)pg/ml, U=690.000, P=0.002], body weight (63.7±11.9kg vs. 58.2±10.2kg, t=2.390, P=0.019), body
mass index (BMI) (23.9±3.5kg/m2 vs. 22.2±3.1kg/m2, t=2.484, P=0.015), body surface area (BSA) (1.7±0.2m2
vs. 1.6±0.2m2, t=2.051, P=0.043), and incidence of edema (67.7% vs. 30.6%, c2=12.322, P＜0.001) were higher, as compared with those in the control group (E/e’≤14). Logistic regression indicated that higher NT-proBNP (OR=5.790, 95% CI 1.724～19.440, P=0.004), increased BMI (OR=1.226, 95% CI 1.028～1.462,
P=0.023) and edema (OR=3.827, 95% CI 1.190～12.310, P=0.024) were the independent risk factors for ab-normal left ventricular diastolic function in PD patients with normal eject fraction. Conclusion Edema, higher NT-proBNP and increased BMI are independently correlated with abnormal left ventricular diastolic function in maintenance PD patients with normal ejection fraction
ZHANG Qian-Ying
,
XU Tian
,
LI Xiao
,
HUANG Xiao-Min
,
ZHANG Chun-Yan
,
REN Hong
. Screening and risk factor analyses of abnormal left ventricular diastolic function in maintenance peritoneal dialysis patients[J]. Chinese Journal of Blood Purification, 2022
, 21(07)
: 487
-491
.
DOI: 10.3969/j.issn.1671-4091.2022.07.006
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