Influences of long-term CAPD on cardiac function

• Published in: Journal of Japanese Society for Dialysis Therapy Vol. 22; no. 1; pp. 61 - 69
• Main Authors: Ohta, Makoto, Kameda, Chikako, Mizuguchi, Masato, Sato, Shigeaki, Tanaka, Hiroshi, Takamizawa, Shigetaka, Sugimoto, Ken-ichi, Miyahara, Tadashi, Kawaguchi, Yoshindo, Ohmura, Nobuhiro
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Dialysis Therapy 1989
• Subjects: cardiac electrical axis; cardiac function; continuous ambulatory peritoneal dialysis (CAPD); ultrasonic echocardiography (UCG); vector electrocardiography (VCG)
• ISSN: 0911-5889; 1884-6211
• DOI: 10.4009/jsdt1985.22.61

To explore the influences of CAPD on cardiac function, hemodynamic changes were evaluated by ultrasonic echocardiography (UCG) in patients with chronic renal failure undergoing long-term CAPD. The subjects consisted of 10 patients who had been on CAPD for at least 3 years. Left ventricular diastolic dimension (LVDd), left ventricular systolic dimension (LVDs), intraventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), E-point septal separation (EPSS), and inferior vena cava dimension (IVCD) were measured by UCG, and the following parameters were calculated: cardiac index (CI), stroke volume (SV), ejection fraction (EF), fractional shortening (FS). These parameters were measured on two separate occasions, one shortly after the initiation of CAPD (less than 2 months, Stage 1) and the other 3 years after regular CAPD (Stage 2). In the latter stage, a vector electrocardiograph (VCG) and electrocardiograph (ECD) were also recorded before and after drainage of the dialysis fluid. The following observations were made: (1) Instillation of the dialysis fluid did not affect any of the parameters except for IVCD, which was slightly decreased at both Stage 1 and 2; (2) IVST and LVPWT at Stage 2 were greater than at Stage 1. LVDs, LVDd, SV and CI were not significantly different from each other at Stage 1 and Stage 2. EF, FS and EPSS tended to improve after long-term CAPD. There was no significant change in IVCD upon comparison between Stage 1 and Stage 2; (3) The electrical axis of the heart was not changed by instillation of dialysis fluid, indicating no significant deviation of cardiac electrical position; (4) As compared with our previous study performed in patients under long-term hemodialysis (HD), CAPD had less influence on these parameters; (5) Deterioration of cardiac function was prevented by antihypeertensive treatment in patients with hypertension. in long-term CAPD. The present observations indicate that cardiac work did not increase, and that left ventricular contraction and compliance were well preserved in patients on long-term CAPD. It thus appears that CAPD is a favorable dialysis modality in terms of cardiac function, in comparison with HD.