title: Alteration of cardiovascular structure and function in patients undergoing peritoneal dialysis.
abstract: OBJECTIVE
  Cardiovascular alterations contribute to a high mortality rate in patients with end-stage renal disease (ESRD). The aims of the present study are to evaluate left ventricular (LV) function and common carotid artery (CCA) parameters and to determine risk factors associated with these changes in patients undergoing peritoneal dialysis (PD).
  
  
  METHODS
  This longitudinal prospective study was conducted in 50 ESRD patients in whom PD had been initiated and who were observed for 18 months after the commencement of dialysis treatment, with echocardiography and CCA ultrasound parameter evaluation.
  
  
  RESULTS
  LV hypertrophy was observed in 78% of patients at baseline and in 60% after 18 months of PD treatment. LV systolic and diastolic function was found to be significantly better after 18 months of PD treatment. Examining predictors of LV systolic function, it was found that total cholesterol was an independent positive predictor and endothelin-1 (ET-1) an independent negative predictor of LV systolic function after 18 months of treatment with PD (p < 0.001). Independent negative predictors of diastolic LV function were hemoglobin and type 2 diabetes mellitus, and daily collection of urine was an independent positive predictor (p < 0.001). Female gender was an independent negative predictor of CCA intima-media thickness, whereas body mass index, ET-1 and C-reactive protein were independent positive predictors (p < 0.001).
  
  
  CONCLUSIONS
  The results suggest several novel modifiable mechanisms related to the short-term effects of dialysis that are potentially implicated in the development of uremic cardiomyopathy.
authors.affiliation: Clinic for Nephrology, University Clinical Center of Sarajevo, Bosnia and Herzegovina.
authors.forename: Damir R
authors.initials: DR
authors.lastname: Rebić
authors.affiliation: Clinic for Nephrology, University Clinical Center of Sarajevo, Bosnia and Herzegovina.
authors.forename: Senija R
authors.initials: SR
authors.lastname: Rašić
authors.affiliation: University of Sarajevo, School of Medicine, Sarajevo, Bosnia and Herzegovina.
authors.forename: Muamer D
authors.initials: MD
authors.lastname: Dervišević
authors.affiliation: Clinic for Nephrology, University Clinical Center of Sarajevo, Bosnia and Herzegovina.
authors.forename: Aida H M
authors.initials: AH
authors.lastname: Hamzić-Mehmedbašić
authors.affiliation: Clinic for Nephrology, University Clinical Center of Sarajevo, Bosnia and Herzegovina.
authors.forename: Alma M
authors.initials: AM
authors.lastname: Muslimović
authors.affiliation: Clinic for Nephrology, University Clinical Center of Sarajevo, Bosnia and Herzegovina.
authors.forename: Edina H
authors.initials: EH
authors.lastname: Hasanagić
keywords: Atherosclerosis; End-stage renal disease; Left ventricle; Peritoneal dialysis