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Clinical |
ci
Department of Nephrology, Ege University Medical School, Izmir, Turkey
Correspondence to: G. Aci, Department of Nephrology, Ege University
Medical School, Izmir,
Turkey.gulayas{at}hotmail.com;
nephrol{at}med.ege.edu.tr
Background: This study was undertaken to investigate
the effect of long-term blood pressure (BP) reduction, achieved with salt
restriction and strict volume control, on frequency and regression of left
ventricular hypertrophy (LVH) in long-term peritoneal dialysis (PD)
patients. Methods: 56 patients who had been treated for more than
2 years under our care were enrolled. After echocardiographic (Echo)
evaluation, 46 patients were included in the follow-up study. In our unit, we
aim to keep patients' BP below 130/85 mmHg and cardiothoracic index below
0.50. To reach these targets, moderate salt restriction is advised, and if
necessary, hypertonic PD solutions are used. Echo was performed at the
beginning of the study (after a mean period of 36 months on PD) and at the end
of the prospective follow-up period (24 months later). Results: At the time of the first Echo, LVH was
detected in only 8 (21%) patients. Residual urine volume was significantly
decreased compared to data taken when they first started PD (658 ± 795
vs 236 ± 307 mL/day). Mean left ventricular mass index (LVMI) was 107
± 26.5 g/m2. LVMI was significantly decreased at the end of
the follow-up in patients who had LVH at baseline. No LVH developed in
patients who had normal LVMI at baseline. Conclusion: Our results indicate that control of
hypertension is possible when extracellular fluid volume is kept under control
using hypertonic PD solutions in case of recruitment in addition to salt
restriction in long-term PD patients. Sustained normovolemia is associated
with low incidence and regression of LVH.
KEY WORDS: Hypertension; volume control; left ventricular hypertrophy.
Received 26 August 2004; accepted 14 June 2005.
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L. Segall and A. Covic Cardiovascular disease in haemodialysis and peritoneal dialysis: arguments pro haemodialysis Nephrol. Dial. Transplant., January 1, 2007; 22(1): 59 - 63. [Full Text] [PDF]
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