Effect Of Residual Renal Function On Left Ventricular Structure And Function In Peritoneal Dialysis Patients

Objective:To explore the effect of residual renal function on left ventricular structure and function in peritoneal dialysis patients.Methods:According to the inclusion and exclusion criteria,81 patients with peritoneal dialysis(PD)who were admitted to the Department of Nephrology of the First Hospital of Shanxi Medical University from October 2021 to October 2022 were selected and divided into two groups based on the level of residual renal function(RRF): the RRF(+)group(KRU≥1.5ml/min)and the RRF(-)group(KRU<1.5 ml/min).Collect patients’ general information,laboratory indicators,left ventricular structural indicators,and cardiac function indicators,compare the differences between the two groups in various indicators and the status of cardiac valve calcification,and use Pearson or Spearman correlation analysisto analyze the correlation between RRF and clinical indicators.Results:(1)Among 81 peritoneal dialysis patients,39(48.15%)patients were in the RRF(+)group and 42(51.85%)patients were in the RRF(-)group.Compared with the RRF(+)group,the RRF(-)group had an increase in systolic blood pressure,a decrease in urine volume and Kt/V,the difference was statistically significant(P<0.01).(2)Compared with RRF(+)group,hemoglobin(Hb)in RRF(-)group significantly decreased,while blood phosphorus(P),calcium phosphorus product,serum creatinine(Scr),N-terminal pro BNP(NT-pro BNP),hypersensitive C-reactive protein(hs-CRP),and cystatin C(Cys C)were significantly increased in RRF(-)group,the difference was statistically significant(P<0.05).(3)Compared between the two groups,the left ventricular mass index(LVMI),Interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end systolic diameter(LVESD),and left ventricular end diastolic diameter(LVEDD)in the RRF(-)group were higher than those in the RRF(+)group,and the left ventricular ejection fraction(LVEF)and fractional shortening(FS)were lower than those in the RRF(+)group,the difference was statistically significant(P<0.01).There was no significant difference in E/A between the two groups(P>0.05).(4)Correlation analysis showed that RRF was negatively correlated with systolic blood pressure(r=-0.289,P=0.009),Scr(r=-0.407,P<0.001),P(r=-0.327,P=0.003),calcium phosphate product(r=-0.231,P=0.038),hs-CRP(r=-0.456,P<0.001),NT-pro BNP(r=-0.651,P<0.001),cystatin C(r=-0.481,P<0.001),LVMI(r=-0.623,P<0.001),IVST(r=-0.307,P=0.005),LVPWT(r=-0.368,P=0.001),LVESD(r=-0.267,P=0.016),LVEDD(r=-0.280,P=0.011),and positively correlated with urine volume(r=0.736,P<0.001),Kt/V(r=0.726,P<0.001),Hb(r=0.284,P=0.010),LVEF(r=0.448,P<0.001),and FS(r=0.289,P=0.009).(5)Among 81 patients with PD,31(38.27%)patients had cardiac valve calcification and 50(61.73%)patients had no calcification.Compared with RRF(+)group,the incidence of cardiac valve calcification in RRF(-)group was significantly higher,the difference was statistically significant(P<0.05).Conclusions:The loss of residual renal function in peritoneal dialysis patients is closely related to changes in left ventricular structure,decreased cardiac function,and an increase in the incidence of cardiac valve calcification.Protection of residual kidney function can delay abnormal cardiac changes of peritoneal dialysis patients and reduce the occurrence of cardiovascular events.