title: High Prevalence of Diastolic Dysfunction in Incident Patients on Peritoneal Dialysis: Association with Low Thyroid Hormones.
abstract: OBJECTIVE
  Diastolic dysfunction (DD) and low levels of thyroid hormones (TH) are frequent found in chronic kidney disease; both are associated with all-cause and cardiovascular mortality. However, a link between them has not yet been established. The aim of this study was to analyze DD as a surrogate marker of fibrosis and its association with TH in incident patients on peritoneal dialysis (PD).
  
  
  METHODS
  A cross-sectional study with 183 incident patients on PD with preserved ejection fraction was performed. Clinical and demographic data were registered. Serum total and free (t/f) triiodothyronine (T3), thyroxin (T4), and thyroid stimulating hormone levels were determined by RIA kits, albumin and high-sensitivity C-reactive protein by conventional assays. Transthoracic 2D echocardiogram was performed for evaluation of left ventricular (LV) mass and ejection fraction. DD was evaluated using pulsed-wave tissue Doppler imaging.
  
  
  RESULTS
  Patients were 43 ± 12, 42% with diabetes mellitus (DM). Some degree of DD was found in 62% of patients; 18% had grade I DD, 8% grade II DD and 36% grade III DD. Patients with grade III DD were more likely to have diabetes, older, high LV mass and low serum albumin, t/fT3 and tT4 levels. In logistic multivariate regression analysis, it was found that diabetes (B = -0.86, 95% CI 0.182-0.992, p < 0.05), hypertension (B = -0.95, 95% CI 0.184-0.817, p = 0.01) and tT3 (B = -1.94, 95% CI 0.023-0.876, p < 0.05) were associated with grade III DD.
  
  
  CONCLUSIONS
  High prevalence of grade III DD was found in incident patients on PD. In addition to DM and hypertension, tT3 was found to be an independent risk factor for grade III DD and more studies are needed to understand the reasons as to why this association is present.
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades, CMN, SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Virginia
authors.initials: V
authors.lastname: Sánchez
authors.forename: Ramón
authors.initials: R
authors.lastname: Paniagua
authors.forename: Maria Del Carmen
authors.initials: MD
authors.lastname: Prado
authors.forename: Carmen
authors.initials: C
authors.lastname: Mora
authors.forename: Oscar
authors.initials: O
authors.lastname: Orihuela
authors.forename: Francisco
authors.initials: F
authors.lastname: Martínez-Baca
authors.forename: Estela Elizabeth
authors.initials: EE
authors.lastname: Pérez
authors.forename: Claudia
authors.initials: C
authors.lastname: Calzada
authors.forename: Renata
authors.initials: R
authors.lastname: Romero
authors.forename: Marcela
authors.initials: M
authors.lastname: Avila
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D013963:Thyroid Hormones / Q000172:deficiency*; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology
chemical_list: D013963:Thyroid Hormones