Right Ventricular Function in End-stage Renal Disease Patients

The Impact of Different Dialysis Modalities on Right Ventricular Function in End-stage Renal Disease Patients

Right ventricular (RV) dysfunction is a major cause of heart failure and mortality in end-stage renal disease (ESRD) patients. The aim of the study was to evaluate the long-term impacts of different dialysis modalities on RV function assessed by conventional echocardiography in ESRD patients with preserved left ventricular function. The study included 83 ESRD patients grouped as follows: peritoneal dialysis (PD; n=46) and hemodialysis with brachial arterio-venous fistula (HD; n=37). Conventional echocardiography including 2D and tissue Doppler imaging was performed in all patients. Echocardiographic parameters were compared between groups.

Study Overview

• Status: Completed
• Conditions: Hemodialysis; Transthoracic Echocardiography
• Intervention / Treatment: Diagnostic test: Transthoracic echocardiography

Detailed Description

Cardiovascular diseases (CVD) are the main causes of death in patients undergoing dialysis. Right ventricular (RV) dysfunction is one of the major predictors of mortality and heart failure in this patient group. It has been shown that patients undergoing hemodialysis (HD) which is usually carried out via a surgically created arteriovenous fistula (AVF) have an increased risk for pulmonary hypertension and poorer right ventricular function compared with healthy controls . However, there are few data comparing the patients undergoing HD and peritoneal dialysis (PD), in terms of echocardiographic right ventricular function.

The aim of the present study was to elucidate the impact of both long term PD and HD therapy via brachial AVF on RV function in patients with preserved left ventricular (LV) function.

Patients undergoing dialysis were grouped as follows: 46 patients on PD and 37 patients on HD with brachial AVF. All of the study patients underwent transthoracic echocardiography. Left and right ventricular parameters were compared between two groups.

• Study Type: Observational
• Enrollment (Actual): 83

Contacts and Locations

Study Locations

• Turkey
  • Antalya, Turkey
    • Antalya Research and Training Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

End-stage renal disease patients on a regular dialysis program at least 6 months

Description

Inclusion Criteria:

• End-stage renal disease patients on a regular dialysis program
• Being on dialysis at least 6 months
• >18 years old

Exclusion Criteria:

• Ischemic heart disease
• Left ventricular systolic dysfunction with an ejection fraction (EF) of less than 55 %
• Valvulopathy
• Left bundle branch block
• Atrial fibrilation
• Previous renal transplantation
• Chronic obstructive pulmonary disease
• Interstitial lung diseases
• Connective tissue disorders
• Chronic thromboembolic disease
• Congenital left-to-right shunt
• Primary pulmonary hypertension

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
hemodialysis patients; end-stage renal disease patients on hemodialysis	Diagnostic test: Transthoracic echocardiography; Conventional 2-D transthoracic echocardiography was performed to all patients
peritoneal dialysis patients; end-stage renal disease patients on peritoneal dialysis	Diagnostic test: Transthoracic echocardiography; Conventional 2-D transthoracic echocardiography was performed to all patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Estimation of right ventricular function in end-stage renal disease patients	Transthoracic echocardiography was performed to end-stage renal disease patients on hemodialysis and peritoneal dialysis for at least 6 months. Tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV FAC), Right ventricular myocardial performance index (RV MPI) and right ventricular lateral peak annular systolic velocity (Sa) were measured to estimate right ventricular function.	1 week

Collaborators and Investigators

• Sponsor: Antalya Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2019
• Primary Completion (ACTUAL): March 1, 2020
• Study Completion (ACTUAL): July 1, 2020

Study Registration Dates

• First Submitted: August 20, 2020
• First Submitted That Met QC Criteria: August 20, 2020
• First Posted (ACTUAL): August 24, 2020

Study Record Updates

• Last Update Posted (ACTUAL): August 26, 2020
• Last Update Submitted That Met QC Criteria: August 22, 2020
• Last Verified: August 1, 2020

More Information

Terms related to this study

• Keywords: echocardiography; peritoneal dialysis; hemodialysis; right ventricle
• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Renal Insufficiency; Renal Insufficiency, Chronic; Kidney Failure, Chronic
• Other Study ID Numbers: 2019-398

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No