Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 2, March-April, p. 251–258

doi: 10.17219/acem/64936

Publication type: original article

Language: English

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Dialysis vintage and cardiovascular injury as factors influencing long-term survival in peritoneal dialysis and hemodialysis

Krzysztof Hoppe1,A,B,C,D,F, Krzysztof Schwermer1,A,B,C,F, Anna Olewicz-Gawlik1,B,C,E, Patrycja Klysz2,B,C, Anna Kawka1,B,C,E, Ewa Baum3,B,C,E, Dorota Sikorska2,B,C, Katarzyna Ścigacz1,B,D, Magdalena Roszak4,C, Bengt Lindholm5,E,F, Krzysztof Pawlaczyk1,5,A,C,E,F, Andrzej Oko1,E,F

1 Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland

2 Department of Pathophysiology, Poznan University of Medical Sciences, Poland

3 Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poland

4 Department of Biostatistics, Poznan University of Medical Sciences, Poland

5 Karolinska Institutet, Clinical Science, Intervention and Technology, Stockholm, Sweden

Abstract

Background. Cardiovascular (CV) incidents are the major cause of mortality in maintenance dialysis (MD) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD). CV injury indicators may be useful to investigate the dialysis modality influence on survival.
Objectives. The aim of this study was to compare selected laboratory and echocardiographic (ECHO) markers of CV injury in terms of dialysis vintage (DV), CV-related mortality and all-cause mortality.
Material and Methods. The study involved 301 patients on HD (n = 301) and PD (n = 58), who were divided into subgroups according to DV. The subjects’ medical histories included diabetes mellitus (DM), myocardial infarction (MI), stroke, CV deaths and deaths from non-CV causes. Their CV parameters were measured with ECHO for the left ventricle ejection fraction (EF), posterior wall (LVW) and interventricular septum (IVS). Serum analyses of cardiac troponin T (TnT) and N-terminal pro-brain natriuretic peptide (BNP) were also carried out.
Results. In the subgroup with a DV of 4 years, the PD and HD patients were of a similar age, and had similar mortality and morbidity rates and CV markers, except for thicker IVS in the HD patients.
Conclusion. Focusing on the data analysis based on mortality, and both laboratory and echocardiographic markers of cardiovascular injury, PD seems to be a more favorable method of dialysis. The advantage of PD was noted in subjects with a DV < 2 years. HD showed no outcome benefit over PD in longer DV.

Key words

hemodialysis, mortality, peritoneal dialysis, echocardiography, troponin T

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