Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis

Seung Jun Kim; Hyung Jung Oh; Dong Eun Yoo; Dong Ho Shin; Mi Jung Lee; Jung Tak Park; Seung Hyeok Han; Tae Hyun Yoo; Kyu Hun Choi; Shin Wook Kang

doi:10.1016/j.echo.2011.12.005

Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis

Seung Jun Kim, Hyung Jung Oh, Dong Eun Yoo, Dong Ho Shin, Mi Jung Lee, Jung Tak Park, Seung Hyeok Han, Tae Hyun Yoo, Kyu Hun Choi, Shin Wook Kang

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Background: Left atrial (LA) volume index (LAVI) has been considered a stable indicator of diastolic dysfunction and an independent predictor of mortality in patients with end-stage renal disease. To date, however, little is known about the relationship between LA enlargement and the changes in residual renal function (RRF). Methods: This study was undertaken to investigate the association between LA enlargement and the decline in RRF in 121 incident peritoneal dialysis patients. Within 2 months after the initiation of peritoneal dialysis, LA enlargement was determined by echocardiography and RRF by 24-hour urine collection. Subsequently, RRF was measured every 6 months. Results: The rates of decline in RRF were significantly greater in patients with LA enlargement (LAVI > 32 mL/m ²) compared with those without LA enlargement (-0.17 ± 0.18 vs -0.07 ± 0.16 mL/min/month/1.73 m ², P = .002). In a linear mixed model, there was a significant difference in the rates of RRF decline over time between patients with and without LA enlargement (P <.001). Pearson's correlation analysis revealed that there were significant inverse correlations between the rates of the decline in RRF and LAVI (r = -0.22, P =.018). In multiple linear regression analysis adjusted for other risk factors, LAVI was found to be an independent determinant of the rates of decline in RRF (β = -0.026, P =.018). Conclusions: This study shows that a higher LAVI is independently associated with a more rapid decline in RRF in patients with end-stage renal disease on peritoneal dialysis.

Original language	English
Pages (from-to)	421-427
Number of pages	7
Journal	Journal of the American Society of Echocardiography
Volume	25
Issue number	4
DOIs	https://doi.org/10.1016/j.echo.2011.12.005
Publication status	Published - 2012 Apr

Bibliographical note

Funding Information:
This work was supported by the Brain Korea 21 Project for Medical Science, Yonsei University , by a National Research Foundation of Korea grant funded by the Korean government ( MEST No. 2011-0030711 ), and by grant A102065 from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare , Republic of Korea.

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.echo.2011.12.005

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Kim, S. J., Oh, H. J., Yoo, D. E., Shin, D. H., Lee, M. J., Park, J. T., Han, S. H., Yoo, T. H., Choi, K. H., & Kang, S. W. (2012). Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis. Journal of the American Society of Echocardiography, 25(4), 421-427. https://doi.org/10.1016/j.echo.2011.12.005

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title = "Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis",

abstract = "Background: Left atrial (LA) volume index (LAVI) has been considered a stable indicator of diastolic dysfunction and an independent predictor of mortality in patients with end-stage renal disease. To date, however, little is known about the relationship between LA enlargement and the changes in residual renal function (RRF). Methods: This study was undertaken to investigate the association between LA enlargement and the decline in RRF in 121 incident peritoneal dialysis patients. Within 2 months after the initiation of peritoneal dialysis, LA enlargement was determined by echocardiography and RRF by 24-hour urine collection. Subsequently, RRF was measured every 6 months. Results: The rates of decline in RRF were significantly greater in patients with LA enlargement (LAVI > 32 mL/m 2) compared with those without LA enlargement (-0.17 ± 0.18 vs -0.07 ± 0.16 mL/min/month/1.73 m 2, P = .002). In a linear mixed model, there was a significant difference in the rates of RRF decline over time between patients with and without LA enlargement (P <.001). Pearson's correlation analysis revealed that there were significant inverse correlations between the rates of the decline in RRF and LAVI (r = -0.22, P =.018). In multiple linear regression analysis adjusted for other risk factors, LAVI was found to be an independent determinant of the rates of decline in RRF (β = -0.026, P =.018). Conclusions: This study shows that a higher LAVI is independently associated with a more rapid decline in RRF in patients with end-stage renal disease on peritoneal dialysis.",

author = "Kim, {Seung Jun} and Oh, {Hyung Jung} and Yoo, {Dong Eun} and Shin, {Dong Ho} and Lee, {Mi Jung} and Park, {Jung Tak} and Han, {Seung Hyeok} and Yoo, {Tae Hyun} and Choi, {Kyu Hun} and Kang, {Shin Wook}",

note = "Funding Information: This work was supported by the Brain Korea 21 Project for Medical Science, Yonsei University , by a National Research Foundation of Korea grant funded by the Korean government ( MEST No. 2011-0030711 ), and by grant A102065 from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare , Republic of Korea. ",

year = "2012",

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doi = "10.1016/j.echo.2011.12.005",

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T1 - Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis

AU - Kim, Seung Jun

AU - Oh, Hyung Jung

AU - Yoo, Dong Eun

AU - Shin, Dong Ho

AU - Lee, Mi Jung

AU - Park, Jung Tak

AU - Han, Seung Hyeok

AU - Yoo, Tae Hyun

AU - Choi, Kyu Hun

AU - Kang, Shin Wook

N1 - Funding Information: This work was supported by the Brain Korea 21 Project for Medical Science, Yonsei University , by a National Research Foundation of Korea grant funded by the Korean government ( MEST No. 2011-0030711 ), and by grant A102065 from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare , Republic of Korea.

PY - 2012/4

Y1 - 2012/4

N2 - Background: Left atrial (LA) volume index (LAVI) has been considered a stable indicator of diastolic dysfunction and an independent predictor of mortality in patients with end-stage renal disease. To date, however, little is known about the relationship between LA enlargement and the changes in residual renal function (RRF). Methods: This study was undertaken to investigate the association between LA enlargement and the decline in RRF in 121 incident peritoneal dialysis patients. Within 2 months after the initiation of peritoneal dialysis, LA enlargement was determined by echocardiography and RRF by 24-hour urine collection. Subsequently, RRF was measured every 6 months. Results: The rates of decline in RRF were significantly greater in patients with LA enlargement (LAVI > 32 mL/m 2) compared with those without LA enlargement (-0.17 ± 0.18 vs -0.07 ± 0.16 mL/min/month/1.73 m 2, P = .002). In a linear mixed model, there was a significant difference in the rates of RRF decline over time between patients with and without LA enlargement (P <.001). Pearson's correlation analysis revealed that there were significant inverse correlations between the rates of the decline in RRF and LAVI (r = -0.22, P =.018). In multiple linear regression analysis adjusted for other risk factors, LAVI was found to be an independent determinant of the rates of decline in RRF (β = -0.026, P =.018). Conclusions: This study shows that a higher LAVI is independently associated with a more rapid decline in RRF in patients with end-stage renal disease on peritoneal dialysis.

AB - Background: Left atrial (LA) volume index (LAVI) has been considered a stable indicator of diastolic dysfunction and an independent predictor of mortality in patients with end-stage renal disease. To date, however, little is known about the relationship between LA enlargement and the changes in residual renal function (RRF). Methods: This study was undertaken to investigate the association between LA enlargement and the decline in RRF in 121 incident peritoneal dialysis patients. Within 2 months after the initiation of peritoneal dialysis, LA enlargement was determined by echocardiography and RRF by 24-hour urine collection. Subsequently, RRF was measured every 6 months. Results: The rates of decline in RRF were significantly greater in patients with LA enlargement (LAVI > 32 mL/m 2) compared with those without LA enlargement (-0.17 ± 0.18 vs -0.07 ± 0.16 mL/min/month/1.73 m 2, P = .002). In a linear mixed model, there was a significant difference in the rates of RRF decline over time between patients with and without LA enlargement (P <.001). Pearson's correlation analysis revealed that there were significant inverse correlations between the rates of the decline in RRF and LAVI (r = -0.22, P =.018). In multiple linear regression analysis adjusted for other risk factors, LAVI was found to be an independent determinant of the rates of decline in RRF (β = -0.026, P =.018). Conclusions: This study shows that a higher LAVI is independently associated with a more rapid decline in RRF in patients with end-stage renal disease on peritoneal dialysis.

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Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis

Abstract

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