Disadvantage of long-term CAPD for preserving cardiac performance

An echocardiographic study

Kazuhito Takeda, Masahiko Nakamoto, Hideki Hirakata, Mitsuo Baba, Michiaki Kubo, Masatoshi Fujishima

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

The indices of cardiac performances were compared between 31 continuous ambulatory peritoneal dialysis (CAPD) and 20 long-term hemodialysis (HD) patients. They were subdivided into three groups according to dialysis duration: L-CAPD (n = 16, mean age and CAPD duration were, respectively, 53 ± 8 [SD] years and 77 ± 13 months); S-CAPD (n = 15; 52 ± 12 years, 28 ± 12 months); HD (n = 20; 51 ± 10 years, 162 ± 52 months). The diabetic HD patients (DM-HD; n = 13; 60 ± 13 years of age, 22 ± 11 months) were chosen separately. Thirteen normotensive subjects with normal kidney function (mean age, 57 ± 9 years) were selected as an age-matched control group. There were no significant differences between groups in age, gender, incidence of original kidney disease, or serum biochemical data. The blood pressure and the cardiothoracic ratio in L-CAPD were highest among groups. The indices of left ventricular (LV) hypertrophy as well as LV performance by means of echocardiography or pulsed Doppler were compared. Among nondiabetic dialysis patients, the calculated LV mass index (LVMI) of 166.4 ± 84.3 g/m 2 and the ratio of the peak atrial filling velocity to the peak diastolic flow velocity of 1.25 ± 0.4 in L-CAPD were greatest, and the left ventricular fractional shortening (%FS) of 34.2 ± 10.8% in L-CAPD was smallest. LVMI or %FS of L- CAPD was the same as DM-HD of 161.0 ± 40.7 g/m 2 or 31.6 ± 8.2%. Possibly, poor control of hypervolemia, which is caused by peritoneal problems induced by either peritonitis or chronic exposure to high-glucose dialysate, causes a substantial cardiac preload leading to incipient cardiac failure in L-CAPD. According to the similar results of L-CAPD and DM-HD, it may be that hypertension, hyperlipidemia, or long-term constant glucose loading of CAPD fluids in addition to impaired glucose tolerance by chronic renal failure is more or less related to the progression of LV hypertrophy and latent cardiac dysfunction in long-term CAPD patients. In this context, CAPD of more than 5 years' duration is disadvantageous for preserving cardiac function as compared with HD.

Original languageEnglish
Pages (from-to)482-487
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume32
Issue number3
DOIs
Publication statusPublished - 01-01-1998

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Continuous Ambulatory Peritoneal Dialysis
Renal Dialysis
Left Ventricular Hypertrophy
Dialysis
Doppler Pulsed Echocardiography
Glucose
Glucose Intolerance
Ascitic Fluid
Dialysis Solutions
Kidney Diseases
Hyperlipidemias
Peritonitis
Chronic Kidney Failure
Research Design
Heart Failure
Age Groups

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Takeda, Kazuhito ; Nakamoto, Masahiko ; Hirakata, Hideki ; Baba, Mitsuo ; Kubo, Michiaki ; Fujishima, Masatoshi. / Disadvantage of long-term CAPD for preserving cardiac performance : An echocardiographic study. In: American Journal of Kidney Diseases. 1998 ; Vol. 32, No. 3. pp. 482-487.
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Disadvantage of long-term CAPD for preserving cardiac performance : An echocardiographic study. / Takeda, Kazuhito; Nakamoto, Masahiko; Hirakata, Hideki; Baba, Mitsuo; Kubo, Michiaki; Fujishima, Masatoshi.

In: American Journal of Kidney Diseases, Vol. 32, No. 3, 01.01.1998, p. 482-487.

Research output: Contribution to journalArticle

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T1 - Disadvantage of long-term CAPD for preserving cardiac performance

T2 - An echocardiographic study

AU - Takeda, Kazuhito

AU - Nakamoto, Masahiko

AU - Hirakata, Hideki

AU - Baba, Mitsuo

AU - Kubo, Michiaki

AU - Fujishima, Masatoshi

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N2 - The indices of cardiac performances were compared between 31 continuous ambulatory peritoneal dialysis (CAPD) and 20 long-term hemodialysis (HD) patients. They were subdivided into three groups according to dialysis duration: L-CAPD (n = 16, mean age and CAPD duration were, respectively, 53 ± 8 [SD] years and 77 ± 13 months); S-CAPD (n = 15; 52 ± 12 years, 28 ± 12 months); HD (n = 20; 51 ± 10 years, 162 ± 52 months). The diabetic HD patients (DM-HD; n = 13; 60 ± 13 years of age, 22 ± 11 months) were chosen separately. Thirteen normotensive subjects with normal kidney function (mean age, 57 ± 9 years) were selected as an age-matched control group. There were no significant differences between groups in age, gender, incidence of original kidney disease, or serum biochemical data. The blood pressure and the cardiothoracic ratio in L-CAPD were highest among groups. The indices of left ventricular (LV) hypertrophy as well as LV performance by means of echocardiography or pulsed Doppler were compared. Among nondiabetic dialysis patients, the calculated LV mass index (LVMI) of 166.4 ± 84.3 g/m 2 and the ratio of the peak atrial filling velocity to the peak diastolic flow velocity of 1.25 ± 0.4 in L-CAPD were greatest, and the left ventricular fractional shortening (%FS) of 34.2 ± 10.8% in L-CAPD was smallest. LVMI or %FS of L- CAPD was the same as DM-HD of 161.0 ± 40.7 g/m 2 or 31.6 ± 8.2%. Possibly, poor control of hypervolemia, which is caused by peritoneal problems induced by either peritonitis or chronic exposure to high-glucose dialysate, causes a substantial cardiac preload leading to incipient cardiac failure in L-CAPD. According to the similar results of L-CAPD and DM-HD, it may be that hypertension, hyperlipidemia, or long-term constant glucose loading of CAPD fluids in addition to impaired glucose tolerance by chronic renal failure is more or less related to the progression of LV hypertrophy and latent cardiac dysfunction in long-term CAPD patients. In this context, CAPD of more than 5 years' duration is disadvantageous for preserving cardiac function as compared with HD.

AB - The indices of cardiac performances were compared between 31 continuous ambulatory peritoneal dialysis (CAPD) and 20 long-term hemodialysis (HD) patients. They were subdivided into three groups according to dialysis duration: L-CAPD (n = 16, mean age and CAPD duration were, respectively, 53 ± 8 [SD] years and 77 ± 13 months); S-CAPD (n = 15; 52 ± 12 years, 28 ± 12 months); HD (n = 20; 51 ± 10 years, 162 ± 52 months). The diabetic HD patients (DM-HD; n = 13; 60 ± 13 years of age, 22 ± 11 months) were chosen separately. Thirteen normotensive subjects with normal kidney function (mean age, 57 ± 9 years) were selected as an age-matched control group. There were no significant differences between groups in age, gender, incidence of original kidney disease, or serum biochemical data. The blood pressure and the cardiothoracic ratio in L-CAPD were highest among groups. The indices of left ventricular (LV) hypertrophy as well as LV performance by means of echocardiography or pulsed Doppler were compared. Among nondiabetic dialysis patients, the calculated LV mass index (LVMI) of 166.4 ± 84.3 g/m 2 and the ratio of the peak atrial filling velocity to the peak diastolic flow velocity of 1.25 ± 0.4 in L-CAPD were greatest, and the left ventricular fractional shortening (%FS) of 34.2 ± 10.8% in L-CAPD was smallest. LVMI or %FS of L- CAPD was the same as DM-HD of 161.0 ± 40.7 g/m 2 or 31.6 ± 8.2%. Possibly, poor control of hypervolemia, which is caused by peritoneal problems induced by either peritonitis or chronic exposure to high-glucose dialysate, causes a substantial cardiac preload leading to incipient cardiac failure in L-CAPD. According to the similar results of L-CAPD and DM-HD, it may be that hypertension, hyperlipidemia, or long-term constant glucose loading of CAPD fluids in addition to impaired glucose tolerance by chronic renal failure is more or less related to the progression of LV hypertrophy and latent cardiac dysfunction in long-term CAPD patients. In this context, CAPD of more than 5 years' duration is disadvantageous for preserving cardiac function as compared with HD.

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