Comparison of Ventricular and Atrial Geometry and Functions in Dialysis Patients

Purpose: There are few studies comparing echocardiography in patients on peritoneal dialysis (PD) and hemodialysis (HD) although, comparison of cardiac changes between the two groups provides important prognostic information. Methods In 47 PD and 58 HD patients with no known cardiovascular disease, we performed pulse wave Doppler, tissue Doppler and speckle tracking echocardiography. We studied HD patients both before and after HD. Results Mitral E, mitral E/A, medial e', lateral e', mean E/e', tricuspid E/A, tricuspid s', tricuspid e', and tricuspid annular plane systolic excursion (TAPSE) were lower in PD patients compared to HD patients before HD (p:0.000, p:0.000, p:0.001, p:0.032, p:0.008, p:0.000, p:0.027, p:0.028, p:0.002, respectively). Medial a’, tricuspid E, tricuspid A, tricuspid DT, and TAPSE were significantly higher in PD patients compared to HD patients after HD (p = 0.02, p = 0.009, p = 0.023 and p = 0.001, respectively). GLS LV, LAVmax, LAVmin, and LAVI levels after HD were lower compared to levels seen in PD patients (p:0.001, p:0.000, p:0.041, p:0.000, respectively). In HD patients, mitral E, mitral A, mitral E/A, medial e', mean E/e', tricuspid E, tricuspid E/A, tricuspid e', tricuspid a', and TAPSE decreased after HD (p:0.000, p:0.000, p:0.001, p:0.001, p:0.000, p:0.000, p:0.000, p:0.000, p:0.021, p:0.000, respectively). Deterioration was observed in GLS-LV, GLS-RV, FWS-RV, SR, and S-CD after HD (p:0.000, p:0.000, p:0.000, p:0.030, p:0.002, respectively). Conclusion Strain values worsen both in PD and HD patients. HD deteriorates systolic and diastolic functions. The negative effect of dialysis on systolic function is higher in HD compared to PD.