Analysis on correlative factors of left ventricular hypertrophy in patients with peritoneal dialysis

doi:10.3877/cma.j.issn.2095-3216.2016.06.005

Abstract

Abstract:

Objective

To investigate about the development and correlative factors of left ventricular hypertrophy (LVH) in patients with peritoneal dialysis.

Methods

89 patients were enrolled who had received regular peritoneal dialysis for more than 6 months in the First Affiliated Hospital of Guangxi Medical University from September 1st, 2012 to September 1st, 2013. Exclusion criteria included patients who had a history of peritonitis or other infections within 1 month, who were complicated with acute heart failure, chronic obstructive pulmonary disease, cancer, acute cardio-cerebrovascular lesions, rheumatic heart disease, serious liver failure, or who had received treatment with glycocorticosteroids and immunosuppressors within 3 months. The clinical data of selected cases were collected, and echocardiography examination was given, with the left ventricular mass index (LVMI) being calculated through by measuring interventricular septum thickness, left ventricular thickness, and left ventricular diastolic internal diameter. The LVH was defined as LVMI ≥115 g/m² in male, and ≥95 g/m² in female. The SPSS 17.0 statistical software was used for data analysis, and p< 0.05 indicated that the difference was statistically significant.

Results

The 89 patients had a male to female ratio of 1.47∶1, aged 48.49±12.27, and the peritoneal dialysis duration was 25.35±24.30 months. The etiology for peritoneal dialysis included chronic glomerulonephritis in 61 cases (68.54%), hypertensive nephropathy in 16 cases (17.98%), diabetic nephropathy in 2 cases (2.25%), and other causes in 10 cases (11.24%). The prevalence of LVH was 74.16% (66 cases). The differences between LVH group and non-LVH group were statistically significant in N-terminal pro-brain natriuretic peptide (NT-proBNP), ratio of peritoneal dialysis solution creatinine to plasma creatinine (D/P), albumin (Alb), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left atrial diameter (LAD), left ventricular posterior wall thickness (LVPWT), and left ventricular septal thickness (LVST) (P<0.05). The LVH was negatively correlated with LVEF (P<0.05), but was positively correlated with NT-proBNP, D/P value, LVEDD, LVESD, LAD, LVPWT, and LVST (P<0.05). The NT-proBNP was an independent risk factor for LVH (P<0.001).

Conclusion

There was a high prevalence rate of LVH in the patients with peritoneal dialysis, which was closely related with nutritional status, volume load, and peritoneal transport type, etc. The NT-proBNP might be a biomarker for evaluation and prediction of LVH in patients with peritoneal dialysis.

Key words: Peritoneal dialysis, Left ventricular hypertrophy, Affecting factor

Ling Pan, Ruixing Yin, Yunhua Liao. Analysis on correlative factors of left ventricular hypertrophy in patients with peritoneal dialysis[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2016, 05(06): 260-264.

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Figures/Tables 3

References 19

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组别	例数	年龄(岁)	性别(男/女)	透析龄(月)	BMI(kg/m²)	NT-proBNP(ng/L)	D/P－	透析量(ml/d)
左室肥厚组	66	48.4±11.6	39/27	25.6±26.9	22.4±3.6	6 805.9±7489.5	0.7±0.1	7 913.0±733.2
非左室肥厚组	23	48.7±14.3	14/9	24.7±14.9	23.8±4.1	1 658.7±2127.9	0.6±0.1	7 969.7±1022.4
检验值	?	1.190	0.022	3.149	2.710	8.467	0.178	0.171
P值	?	0.912	0.881	0.874	0.116	0.002	0.007	0.808
组别	例数	尿量(ml/d)	超滤量(ml/d)	eGFR[ml/(min·1.73 m²)]	总KT/V－	总Ccr(ml/min)	血红蛋白(g/L)	白蛋白(g/L)
左室肥厚组	66	632.0±528.0	643.2±501.7	1.7±2.3	1.7±0.7	62.8±126.0	87.2±20.0	33.5±4.9
非左室肥厚组	23	765.2±542.0	634.4±501.8	1.6±2.3	1.6±0.4	61.1±26.0	92.4±20.6	35.9±4.2
检验值	?	0.180	0.091	0.570	5.156	0.359	0.069	0.186
P值	?	0.303	0.942	0.814	0.305	0.770	0.285	0.046
组别	例数	甲状旁腺素(ng/L)	血钙(mmol/L)	血磷(mmol/L)	血钾(mmol/L)	血糖(mmol/L)	尿素氮(mmol/L)	收缩压(mmHg)	舒张压(mmHg)
左室肥厚组	66	402.1±295.0	2.2±0.3	1.8±0.7	4.0±0.6	5.0±1.0	19.6±5.6	143.3±17.4	87.1±11.5
非左室肥厚组	23	355.8±405.8	2.2±0.2	1.8±0.6	4.3±0.8	4.9±1.1	19.5±5.4	143.4±17.0	87.6±14.8
检验值	?	0.033	0.299	0.210	0.020	0.730	11.033	0.812	0.460
P值	?	0.559	0.235	0.979	0.131	0.907	0.084	0.997	0.871
组别	例数	TC(mmol/L)	LDL(mmol/L)	心胸比－	LVEF(%)	LVEDD(mm)	LVESD(mm)	LVST(mm)	LVPWT(mm)
左室肥厚组	66	5.2±1.1	3.0±0.9	0.5±0.1	64.0±48.5	62.4±5.4	45.4±7.6	12.5±1.2	11.9±1.4
非左室肥厚组	23	5.9±2.7	3.2±1.2	0.5±0.0	87.0±34.4	48.3±5.3	30.4±4.3	10.3±1.5	9.7±1.4
检验值	?	4.358	3.603	0.343	32.30	0.027	8.995	0.337	0.017
P值	?	0.088	0.431	0.886	0.036	<0.001	<0.001	<0.001	<0.001

组别	例数	年龄(岁)	性别(男/女)	透析龄(月)	BMI(kg/m²)	NT-proBNP(ng/L)	D/P－	透析量(ml/d)
左室肥厚组	66	48.4±11.6	39/27	25.6±26.9	22.4±3.6	6 805.9±7489.5	0.7±0.1	7 913.0±733.2
非左室肥厚组	23	48.7±14.3	14/9	24.7±14.9	23.8±4.1	1 658.7±2127.9	0.6±0.1	7 969.7±1022.4
检验值	?	1.190	0.022	3.149	2.710	8.467	0.178	0.171
P值	?	0.912	0.881	0.874	0.116	0.002	0.007	0.808
组别	例数	尿量(ml/d)	超滤量(ml/d)	eGFR[ml/(min·1.73 m²)]	总KT/V－	总Ccr(ml/min)	血红蛋白(g/L)	白蛋白(g/L)
左室肥厚组	66	632.0±528.0	643.2±501.7	1.7±2.3	1.7±0.7	62.8±126.0	87.2±20.0	33.5±4.9
非左室肥厚组	23	765.2±542.0	634.4±501.8	1.6±2.3	1.6±0.4	61.1±26.0	92.4±20.6	35.9±4.2
检验值	?	0.180	0.091	0.570	5.156	0.359	0.069	0.186
P值	?	0.303	0.942	0.814	0.305	0.770	0.285	0.046
组别	例数	甲状旁腺素(ng/L)	血钙(mmol/L)	血磷(mmol/L)	血钾(mmol/L)	血糖(mmol/L)	尿素氮(mmol/L)	收缩压(mmHg)	舒张压(mmHg)
左室肥厚组	66	402.1±295.0	2.2±0.3	1.8±0.7	4.0±0.6	5.0±1.0	19.6±5.6	143.3±17.4	87.1±11.5
非左室肥厚组	23	355.8±405.8	2.2±0.2	1.8±0.6	4.3±0.8	4.9±1.1	19.5±5.4	143.4±17.0	87.6±14.8
检验值	?	0.033	0.299	0.210	0.020	0.730	11.033	0.812	0.460
P值	?	0.559	0.235	0.979	0.131	0.907	0.084	0.997	0.871
组别	例数	TC(mmol/L)	LDL(mmol/L)	心胸比－	LVEF(%)	LVEDD(mm)	LVESD(mm)	LVST(mm)	LVPWT(mm)
左室肥厚组	66	5.2±1.1	3.0±0.9	0.5±0.1	64.0±48.5	62.4±5.4	45.4±7.6	12.5±1.2	11.9±1.4
非左室肥厚组	23	5.9±2.7	3.2±1.2	0.5±0.0	87.0±34.4	48.3±5.3	30.4±4.3	10.3±1.5	9.7±1.4
检验值	?	4.358	3.603	0.343	32.30	0.027	8.995	0.337	0.017
P值	?	0.088	0.431	0.886	0.036	<0.001	<0.001	<0.001	<0.001

分组	低转运(n＝7)	低平均转运(n＝38)	高平均转运(n＝28)	高转运(n＝16)	总计
左室肥厚组	4(57.14)	24(63.16)	24(85.71)	14(87.50)	66(74.16)
非左室肥厚组	3(42.86)	14(36.84)	4(14.28)	2(12.50)	23(25.84)

分组	低转运(n＝7)	低平均转运(n＝38)	高平均转运(n＝28)	高转运(n＝16)	总计
左室肥厚组	4(57.14)	24(63.16)	24(85.71)	14(87.50)	66(74.16)
非左室肥厚组	3(42.86)	14(36.84)	4(14.28)	2(12.50)	23(25.84)

影响因素	r值	P值
NT-proBNP	0.590	<0.001
D/P	0.286	0.007
腹膜转运类型	0.256	0.016
LVEF	－0.222	0.036
LVEDD	0.551	<0.001
LVESD	0.741	<0.001
LVST	0.729	<0.001
LVPWT	0.720	<0.001
LVD	0.676	<0.001

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