ArticleClinical and experimental nephrology2026
An index of left ventricular diastolic dysfunction in patients starting peritoneal dialysis might indicate mortality and peritoneal dialysis discontinuation.
Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe E/e' ratio is recognized as a reliable and sensitive echocardiographic marker of left ventricular diastolic dysfunction (LVDD). Increased E/e' is known to be associated with mortality and cardiovascular events in kidney failure patients undergoing maintenance replacement therapy. To elucidate the prognostic significance of E/e' in patients starting peritoneal dialysis (PD), we investigated the relations between baseline E/e' after PD initiation and death or PD discontinuation.
methodsData were collected retrospectively from patients with the E/e' ratio evaluated early after PD initiation during August 2008 through December 2023. We investigated the association between the average of septal and lateral E/e' (E/e' Avg) and a composite outcome comprising mortality and PD discontinuation within 8 years after PD initiation.
resultsThis study included 74 incident PD patients with median age of 64 years (74% male). The median value of E/e' Avg was 9.4 at the median time of 3.3 months after PD initiation. Based on the cut-off value inferred from receiver operating characteristic analysis, patients were divided into two groups: patients with E/e' Avg ≤ 9.0 and with E/e' Avg > 9.0. Kaplan-Meier analysis indicated the 8-year survival and PD continuation rates as significantly lower for the E/e' Avg > 9.0 group than for the E/e' Avg ≤ 9.0 group (p = .0019). Cox proportional hazards analyses showed E/e' Avg as independently associated with the composite outcome (hazard ratio 1.17, 95% confidence interval 1.07-1.28).
conclusionIncreased E/e' Avg early after PD initiation is associated positively with 8-year mortality and PD discontinuation.
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