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      Left Ventricular Mass Index in End-Stage Renal Disease Patients during Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

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          Abstract

          Background

          One of the primary reasons for high mortality in end-stage renal disease (ESRD) is cardiovascular disease in patients with renal replacement therapy (RRT). Left ventricular hypertrophy (LVH) significantly predicts mortality and cardiovascular events.

          Objectives

          We assess the left ventricular mass index change in two dialysis methods: hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The factors associated with increased left ventricular mass index (LVMI).

          Materials and Methods

          We recruit more than 50 HD patients and 45 CAPD patients with LVH of similar age, gender, dialysis duration, and LVMI for one-year follow-up.

          Results

          The LVMI in the group of HD patients after one year increased from 180.28 ± 45.32 g/m 2 to 212.58 ± 66.22 g/m 2 ( p = 0.001), while the LVMI in the group of patients with CAPD increased from 190.16 ± 66.01 g/m 2 to 197.42 ± 78 g/m 2 ( p = 0.32). Multivariable logistic regression analysis, we demonstrated that dialysis by HD ( β = −1,167, 95% CI: 0.104–0.938, p = 0.036) and anemia treatment lower the goals ( β = 1.9566, 95% CI: 1.466–34.094, p = 0.015) were two factors associated with the progression of the LVMI.

          Conclusion

          The LVH of end-stage renal disease patients with HD treatment is worse than CAPD treatment after a follow-up in one year. Dialysis by periodic hemodialysis and anemia treatment that fails to achieve the goal are risk factors associated with increased progression of LVMI in patients with ESRD.

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          Most cited references16

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          Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

          The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
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            Prevalence and Disease Burden of Chronic Kidney Disease

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              Left ventricular mass monitoring in the follow-up of dialysis patients: prognostic value of left ventricular hypertrophy progression.

              Regression of left ventricular hypertrophy (LVH) in the setting of a well-planned intervention study has been associated with longer survival in hemodialysis patients. Whether changes in left ventricular mass (LVM) in clinical practice predict survival and cardiovascular events in these patients is still unknown. In a prospective study in 161 hemodialysis patients we tested the prognostic value of changes in LVM on survival and incident cardiovascular events. Echocardiography was performed twice, 18 +/- 2 SD months apart. Changes in LVM occurring between the first and the second echocardiographic study were then used to predict mortality and cardiovascular events during the ensuing 29 +/- 13 months. The prognostic value of LVM changes was tested in a multivariate Cox's model with LVM index (LVMI) [expressed as LVM/height(2.71)], included as a covariate to control for regression to the mean. The rate of increase of LVMI was significantly (P= 0.029) higher in patients with incident cardiovascular events than in those without such events. Accordingly, cardiovascular event-free survival in patients with changes in LVMI below the 25th percentile was significantly (P= 0.004) higher than in those with changes above the 75th percentile. In a multiple Cox regression analysis, including age, diabetes, smoking, homocysteine, 1 g/m(2.7)/month increase in LVMI was associated with a 62% increase in the incident risk of fatal and nonfatal cardiovascular events [hazard ratio 1.62 (95% CI 1.13-2.33), P= 0.009]. Changes in LVMI have an independent prognostic value for cardiovascular events and provide scientific support to the use of repeated echocardiographic studies for monitoring cardiovascular risk in dialysis patients.
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                Author and article information

                Contributors
                Journal
                Int J Clin Pract
                Int J Clin Pract
                IJCLP
                International Journal of Clinical Practice
                Hindawi
                1368-5031
                1742-1241
                2023
                11 December 2023
                : 2023
                : 8816478
                Affiliations
                1Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
                2Department of Internal Medicine, Faculty of Medicine, Nam Can Tho University, Can Tho 900000, Vietnam
                Author notes

                Academic Editor: Tun-Chieh Chen

                Author information
                https://orcid.org/0009-0007-6150-1553
                https://orcid.org/0000-0002-0688-4754
                Article
                10.1155/2023/8816478
                10728365
                38115951
                673b6ecb-4c4f-456a-b94f-e3718f8b2d04
                Copyright © 2023 Nghia Nhu Nguyen et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 May 2023
                : 4 September 2023
                : 6 December 2023
                Categories
                Research Article

                Medicine
                Medicine

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