Impact of dialysis modality on ultrasonographic cardiovascular parameters in elderly patients.

Cardiovascular complications are the major cause of mortality in end-stage renal disease (ESRD) patients. Some reports show that ultrasonographic parameters for cardiovascular remodeling predict mortality in ESRD patients as well as in the general population. In the present study, we compared long-term longitudinal changes in cardiac parameters between elderly patients on peritoneal dialysis (PD) and those on hemodialysis (HD). We analyzed 19 HD and 7 PD patients who were more than 75 years old at the start of dialysis and who had been treated with the same dialysis modality for more than 4 years. We compared ultrasonographic cardiovascular parameters such as left ventricular mass index (LVMI), left ventricular wall thickness (LVWT), intima media thickness and intima media area (IMA) over the 4 years of PD and HD treatment. As compared with values at the start of dialysis, values for LVMI, LVWT, and IMA were significantly elevated in HD patients after 4 years of treatment. In PD patients, we observed no changes in those parameters over time. Our findings indicate that cardiovascular remodeling is liable to deteriorate in elderly patients on HD, but that cardiac parameters in PD patients remain rather stable.