Systolic and diastolic function in renal replacement therapy: a cross-sectional study.
BACKGROUND
Heart disease is the main cause of death among uremic patients (pts). Our study aimed to assess left ventricular (LV) systolic and diastolic function in all of our pts on renal replacement therapy (RRT), investigating any differences between hemodialysis (HD), peritoneal dialysis (PD) and transplantation (TX) pts.


METHODS
All pts on RRT at our nephrology unit were enrolled in the study and evaluated once over a period of 6 months: 125 pts were studied: 61 pts on HD, 30 pts on PD and 34 TX pts. Systolic and diastolic function indexes were compared between HD, PD and TX pts. All comparisons were corrected for the effects of age, gender and time on treatment.


RESULTS
HD pts suffered from worse systolic function, with a lower mean fractional shortening and ejection fraction (EF), than TX pts. Twenty percent of HD pts had an EF value <55%. PD pts showed worse diastolic function than TX pts and >80% of them suffered from pathological diastolic indexes. The proportion of hypertensive pts was TX 88.2%, PD 86.7% and HD 50.8%. The percentage of pts with LV hypertrophy (LVH) was TX 55.9%, PD 53.3% and HD 36.1%.


CONCLUSIONS
TX pts had better systolic and diastolic function than HD and PD pts, despite having more hypertension and LVH.
Virga
Giovambattista
G
Nephrology and Dialysis Unit, P. Cosma Hospital, Camposampiero, Padova, Italy. virgolino14@libero.it
Stomaci
Berardino
B
Munaro
Alessandra
A
Mastrosimone
Stefania
S
Cara
Marilena
M
Artuso
Elisabetta
E
Piovesana
Piergiuseppe
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D013599:Systole; D014511:Uremia / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy