Long-term impacts of different dialysis modalities on right ventricular
function in patients with end-stage renal disease
Abstract
Background Right ventricular dysfunction is a major
cause of heart failure and mortality in end-stage renal disease
patients. Scarce data is available regarding the comparison of
echocardiographic right ventricular function in end-stage renal disease
patients on hemodialysis (HD) and peritoneal dialysis (PD). The aim of
the study was to evaluate the long-term impacts of different dialysis
modalities on right ventricular function assessed by conventional
echocardiography, in end-stage renal disease patients with preserved
left ventricular function. Methods The study included
120 patients grouped as follows: PD(n=40), HD with arterio-venous
fistula (n=40) and healthy control subjects (n=40). Conventional
echocardiography was performed in all patients. A classification of
right ventricular function was defined in HD patients by using tricuspid
annular plane systolic excursion (TAPSE), right ventricular myocardial
performance index (RV-MPI), fractional area change (FAC) and tricuspid
lateral annulus systolic velocity (Sa) values. Correlation analysis was
performed by using right ventricular dysfunction score, clinical and
echocardiographic parameters. Results The mean age of
the study population was 51.9±13.1 years and 47.5% were females. TAPSE
and Sa velocity were found to be significantly lower and RV-MPI was
significantly higher in patients undergoing HD, compared with control
and PD patients. Logistic regression analysis showed that HD treatment
was an independent risk factor for developing right ventricular
dysfunction. Conclusion RV function was impaired in
patients undergoing HD compared with patients on PD.