Impact of Hybrid Therapy Comprising Peritoneal Dialysis and Hemodialysis on Acute Cardiovascular Events.

BACKGROUND

The impact of hybrid therapy comprising peritoneal dialysis (PD) and hemodialysis on cardiovascular events in PD patients remains unclear.

OBJECTIVE

We aimed to evaluate the effect of hybrid therapy on cardiovascular events.

METHODS

A total of 93 PD patients undergoing hybrid therapy for ≥3 years were divided into 2 groups according to left ventricular ejection fraction (LVEF): lower ejection fraction (LEF [n = 29], LVEF < 60%) and normal ejection fraction (NEF [n = 64], LVEF ≥60%). Hospitalization rates and echocardiographic parameters were evaluated.

RESULTS

The 1-year hospitalization rate for acute cardiovascular events decreased after the therapy initiation in both groups (LEF: 0.36-0.11, p = 0.02 and NEF: 0.43-0.06, p < 0.001). In generalized linear mixed models, LVEF (44 ± 15%) improved at 1, 2, and 3 years after initiation (53 ± 18, 55 ± 17, and 58 ± 7%; p < 0.05) in the LEF group, whereas, in the NEF group, LVEF (68 ± 5%) was maintained at 1, 2, and 3 years after initiation (67 ± 8, 67 ± 9, and 68 ± 9%; p > 0.05). Mitral inflow E velocity to tissue Doppler e' ratio was maintained at the same level at 1-3 years after initiation in both groups. Left ventricular mass index (LVMI; 189 ± 41 g/m2) was decreased at 1 (178 ± 35 g/m2; p = 0.8), 2 (160 ± 45 g/m2; p = 0.008), and 3 (166 ± 47 g/m2; p = 0.05) years after initiation in the LEF group, whereas in the NEF group, LVMI (157 ± 45 g/m2) was maintained at 1, 2, and 3 years after initiation (153 ± 40, 155 ± 54, and 158 ± 52 g/m2; p > 0.05).

CONCLUSION

Hybrid therapy decreased acute cardiovascular events and improved systolic cardiac function in PD patients in the LEF group.