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Impact of Hybrid Therapy Comprising Peritoneal Dialysis and Hemodialysis on Acute Cardiovascular Events.

Authors :
Banshodani, Masataka
Kawanishi, Hideki
Moriishi, Misaki
Shintaku, Sadanori
Tsuchiya, Shinichiro
Source :
Blood Purification; 2019, Vol. 47 Issue 4, p330-336, 7p
Publication Year :
2019

Abstract

Background: The impact of hybrid therapy comprising peritoneal dialysis (PD) and hemodialysis on cardiovascular events in PD patients remains unclear. Objective: We aimed to evaluate the effect of hybrid therapy on cardiovascular events. Methods: A total of 93 PD patients undergoing hybrid therapy for ≥3 years were divided into 2 groups according to left ventricular ejection fraction (LVEF): lower ejection fraction (LEF [n = 29], LVEF < 60%) and normal ejection fraction (NEF [n = 64], LVEF ≥60%). Hospitalization rates and echocardiographic parameters were evaluated. Results: The 1-year hospitalization rate for acute cardiovascular events decreased after the therapy initiation in both groups (LEF: 0.36–0.11, p = 0.02 and NEF: 0.43–0.06, p < 0.001). In generalized linear mixed models, LVEF (44 ± 15%) improved at 1, 2, and 3 years after initiation (53 ± 18, 55 ± 17, and 58 ± 7%; p < 0.05) in the LEF group, whereas, in the NEF group, LVEF (68 ± 5%) was maintained at 1, 2, and 3 years after initiation (67 ± 8, 67 ± 9, and 68 ± 9%; p > 0.05). Mitral inflow E velocity to tissue Doppler e′ ratio was maintained at the same level at 1–3 years after initiation in both groups. Left ventricular mass index (LVMI; 189 ± 41 g/m<superscript>2</superscript>) was decreased at 1 (178 ± 35 g/m<superscript>2</superscript>; p = 0.8), 2 (160 ± 45 g/m<superscript>2</superscript>; p = 0.008), and 3 (166 ± 47 g/m<superscript>2</superscript>; p = 0.05) years after initiation in the LEF group, whereas in the NEF group, LVMI (157 ± 45 g/m<superscript>2</superscript>) was maintained at 1, 2, and 3 years after initiation (153 ± 40, 155 ± 54, and 158 ± 52 g/m<superscript>2</superscript>; p > 0.05). Conclusion: Hybrid therapy decreased acute cardiovascular events and improved systolic cardiac function in PD patients in the LEF group. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
02535068
Volume :
47
Issue :
4
Database :
Complementary Index
Journal :
Blood Purification
Publication Type :
Academic Journal
Accession number :
136618241
Full Text :
https://doi.org/10.1159/000495357