High-density lipoprotein cholesterol and left ventricular mass index in peritoneal dialysis.

摘要

OBJECTIVE: The prevalence of left ventricular hypertrophy (LVH) reaches 75% in patients with end-stage renal disease. In patients on peritoneal dialysis (PD), some factors, such as hypertension, volume overload, serum albumin, and residual renal function, have been reported to be related to LVH. Dyslipidemia often occurs in PD but it remains unclear whether dyslipidemia is related to LVH. We investigated the relationship between clinical parameters, including lipid profile, and left ventricular mass index (LVMI). METHODS: In this cross-sectional study, 34 patients undergoing PD for more than 1 year without combined therapy with hemodialysis were included. We recorded the patients' clinical data and related those parameters with LVMI as evaluated by echocardiography. RESULTS: The patients included 23 males and 11 females (age 62.2 +/- 12.1 years, duration on PD 31.6 +/- 15.6 months). Mean LVMI was 142 +/- 37 g/m2. In univariate analysis, urine volume (r = -0.493, p = 0.003), total cholesterol (r = -0.418, p = 0.01), high-density lipoprotein cholesterol (HDL-C; r = -0.374, p = 0.02), and human atrial natriuretic peptide (hANP; r = 0.600, p < 0.001) significantly correlated with LVMI. Stepwise multiple regression analysis showed that hANP (beta = 0.524, p = 0.001) and HDL-C (beta = -0.422, p = 0.007) were independently associated with LVMI (r2 = 0.32). CONCLUSION: Strict volume control and salt restriction is essential for prevention of LVH. The role of HDL-C in the development of LVH in PD patients remains to be determined.