Work

The combination of left ventricular ejection fraction and end-diastolic diameter and outcomes in peritoneal dialysis patients: a multicenter retrospective study

Year: 2025

Type: article

Abstract: Background: End-stage renal disease (ESRD) is often complicated by left ventricular dysfunction, which is associated with a poor prognosis. This study aims to investigate the association between baseline left ventricular ejection fraction (LVEF) plus left ventricular end-diastolic diameter (LVEDD) with outcomes in peritoneal dialysis (PD) patients.Methods: In this multicenter retrospective study, 1511 incident Chinese patients on PD between January 1, 2005 and December 31, 2021 were enrolled. Restricted cubic splines (RCS) were used to explore the non-linear associations between LVEF+LVEDD and the risk of mortality. Parametric models for interval-censored survival-time data (stintreg) were used to examine the association between LVEF+LVEDD quartiles and the outcomes.Findings: During 6451·11 person-years of follow-up [median 4·81 (IQR 3·61-6·81) years], 247 (17·8%) patients died, including 88 cardiovascular deaths. RCS showed a U-shaped association between LVEF+LVEDD and the risks of all-cause and CV mortality. According to the quartiles, the optimal range of LVEF+LVEDD associated with the lowest risk of all-cause and CV mortality was 103 to 107, which was set as the reference range. Both higher (≥115) and lower (<103) levels of LVEF+LVEDD were associated with increased risks of all-cause mortality (hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.58-3.07; HR 1·68, 95% CI 1·19-2·36) and cardiovascular mortality (HR 2·51, 95% CI 1·33-4·75; HR 1·86, 95% CI 0·96-3·61).Interpretation: Low and high levels of baseline LVEF+LVEDD were associated with increased risks of all-cause and cardiovascular mortality in PD patients.Funding: This research was funded by National Natural Science Foundation of China (grant number 82270761), Shanghai Leading Talents (grant number 058), Flagship Hospital Construction Project for the Collaboration of Traditional Chinese and Western Medicine [grant number ZY(2021-2023)-0205-04], Portable CRRT equipment development (grant number 2023YFC2411800).Declaration of Interest: The authors declare no conflicts of interest.Ethical Approval: The study protocol was approved by each Clinical Research Ethics Committee, and adhered to the tenets of the declaration of Helsinki. The data were anonymous and the need for informed consent was waived.

Source: Renal Failure

DOI: 10.1080/0886022x.2025.2497493