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Changes in echocardiographic parameters according to the rate of residual renal function decline in incident peritoneal dialysis patients

 Hyang Mo Koo  ;  Fa Mee Doh  ;  Chan Ho Kim  ;  Mi Jung Lee  ;  Eun Jin Kim  ;  Jae Hyun Han  ;  Ji Suk Han  ;  Dong-Ryeol Ryu  ;  Hyung Jung Oh  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang 
 MEDICINE, Vol.94(7) : 427, 2015 
Journal Title
Issue Date
Adult ; Cardiovascular Diseases/epidemiology* ; Cardiovascular Diseases/physiopathology* ; Echocardiography ; Female ; Glomerular Filtration Rate ; Heart Function Tests ; Hematologic Tests ; Humans ; Kidney Failure, Chronic/epidemiology* ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/therapy* ; Kidney Function Tests ; Male ; Middle Aged ; Peritoneal Dialysis/statistics & numerical data* ; Republic of Korea ; Risk Factors
Residual renal function (RRF) is associated with left ventricular (LV) hypertrophy as well as all-cause and cardiovascular (CV) mortality in patients with end-stage renal disease. However, no studies have yet examined the serial changes in echocardiographic findings according to the rate of RRF decline in incident dialysis patients. A total of 81 patients who started peritoneal dialysis (PD) between 2005 and 2012 at Yonsei University Health System, Seoul, South Korea, and who underwent baseline and follow-up echocardiography within the first year of PD were recruited. Patients were dichotomized into "faster" and "slower" RRF decline groups according to the median values of RRF decline slope (-1.60 mL/min/y/1.73 m(2)). Baseline RRF and echocardiographic parameters were comparable between the 2 groups. During the first year of PD, there were no significant changes in LV end-diastolic volume index (LVEDVI), left atrial volume index (LAVI), or LV mass index (LVMI) in the "faster" RRT decline group, while these indices decreased in the "slower" RRT decline group. The rate of RRF decline was a significant determinant of 1-year changes in LVEDVI, LAVI, and LVMI. The linear mixed model further confirmed that there were significant differences in the changes in LVEDVI, LAVI, and LVMI between the 2 groups (P = 0.047, 0.048, and 0.001, respectively). During a mean follow-up duration of 31.9 months, 4 (4.9%) patients died. Compared with the "slower" RRF decline group, CV composite (20.29/100 vs 7.18/100 patient-years [PY], P = 0.098), technique failure (18.80/100 vs 4.19/100 PY, P = 0.006), and PD peritonitis (15.73/100 vs 4.95/100 PY, P = 0.064) developed more frequently in patients with "faster" RRF decline rate. On multivariate Cox regression analysis, patients with "faster" RRF decline rate showed 4.82-, 4.44-, and 7.37-fold higher risks, respectively, for each clinical outcome. Preservation of RRF is important for conserving cardiac performance, resulting in an improvement in clinical outcomes of incident PD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Koo, Hyang Mo(구향모)
Kim, Eun Jin(김은진)
Kim, Chan Ho(김찬호)
Doh, Fa Mee(도화미) ORCID logo https://orcid.org/0000-0002-4780-6728
Ryu, Dong Ryeol(류동열)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
Han, Jae Hyun(한재현)
Hahn, Jee Sook(한지숙)
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