title: Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients.
abstract: OBJECTIVE
  Cardiovascular disease is the leading cause of mortality in dialysis patients with left ventricular hypertrophy (LVH) being an important predictor of mortality. We wanted to determine the prevalence of LVH in peritoneal dialysis (PD) patients and factors contributing to it.
  
  
  METHODS
  This is a cross-sectional study assessing LVH using echocardiogram in PD patients. Left ventricular mass index (LVMI) was calculated to determine LVH. Chronic fluid overload (overhydration) was assessed using the body composition monitor, and blood pressure (BP) was measured using 24-h ambulatory BP monitoring.
  
  
  RESULTS
  Thirty-one patients (21 females:10 males, 48.97 ± 14.50 years and dialysis vintage 40.0 ± 28.9 months) were studied. More than two-thirds (77.4 %) were hypertensive, and a third (35.5 %) were diabetic. Baseline data included mean serum albumin (37.34 ± 4.43 g/l), weekly Kt/V (2.02 ± 0.23), residual renal function of 68 (0-880) ml and ultrafiltration of 1,606.9 ± 548.6 ml. Majority of patients (80.6 %) had LVH on echocardiogram with LVMI of 136.5 ± 37.8 g/m(2) and overhydration of 2.23 ± 1.77 l. Average systolic BP, diastolic BP and mean arterial pressure were 141.2 ± 23.3, 90.8 ± 19.7 and 107.6 ± 19.6 mmHg, respectively. Patients with LVH had a lower serum albumin (p = 0.003), were more overhydrated (p = 0.010) and were on higher number of anti-hypertensive agents (p ≤ 0.001). Predictors of LVMI were overhydration (p = 0.002), the presence of diabetes (p = 0.008) and the number of anti-hypertensive agents used (p = 0.026). However, overhydration (p = 0.007) was the main predictor of LVH on multivariate analysis.
  
  
  CONCLUSIONS
  Overhydration is strongly associated with LVH in PD patients.
authors.affiliation: Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, rizna_c@hotmail.com.
authors.forename: Rizna Abdul
authors.initials: RA
authors.lastname: Cader
authors.forename: Osama Ali
authors.initials: OA
authors.lastname: Ibrahim
authors.forename: Samir
authors.initials: S
authors.lastname: Paul
authors.forename: Halim Abdul
authors.initials: HA
authors.lastname: Gafor
authors.forename: Rozita
authors.initials: R
authors.lastname: Mohd
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D001834:Body Water; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D012709:Serum Albumin