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

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/m2 to 212.58 ± 66.22 g/m2 (p = 0.001), while the LVMI in the group of patients with CAPD increased from 190.16 ± 66.01 g/m2 to 197.42 ± 78 g/m2 (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.

Correlation between nerve conduction changes and BETA-2 microglobulin concentration in chronic kidney disease patients on hemodialysis combined with hemodiafiltration online

This study aimed to investigate the correlation between beta-2 microglobulin (B2M) concentration and some nerve conduction indices and evaluate the changes in some nerve conduction indices after treatment with hemodialysis (HD) combined with hemodiafiltration online in end-stage renal disease patients. From July 2021 to July 2022, a cross-sectional study was conducted on 80 end-stage renal disease patients on HD at Can Tho General Hospital, Viet Nam. All the patients had B2M testing and nerve conduction measurements. Patients with nerve conduction disorders were treated and remeasured after 6 months to evaluate the treatment results. At baseline, there was a moderate negative correlation between B2M and the tibial nerve and motor branch of the ulnar conduction velocity (V) (r = -0.305 and -0.315, P < .05). There was a moderate positive correlation between B2M and motor latency of the tibial and peroneal nerve (r = 0.434 and 0.440, P < .05). After 6 months of using the combination of HD and hemodiafiltration online, the V (31.3 ± 7.96 up to 44.88 ± 9.67 m/s) and the amplitude (A) (1.71 ± 1.16 up to 2.61 ± 1.51 mV) of the peroneal nerve increased, the motor latency decreased (8.21 ± 2.65 down to 5.23 ± 3.58 ms). With the tibial nerve, motor conduction V increased from 30.53 ± 8.05 m/s to 43.56 ± 8.99 m/s and the A increased from 5.04 ± 3.16 mV to 7.75 ± 4.45 mV. With the ulnar nerve, the A increased, and motor latency decreased after 6 months. The nerve conduction indices also improved significantly in the median nerve.