Impact of Hybrid Therapy Comprising Peritoneal Dialysis and Hemodialysis on Acute Cardiovascular Events

Background: The impact of hybrid therapy comprising peritoneal dialysis (PD) and hemodialysis on cardiovascular events in PD patients remains unclear. Objective: We aimed to evaluate the effect of hybrid therapy on cardiovascular events. Methods: A total of 93 PD patients undergoing hybrid therapy for >= 3 years were divided into 2 groups according to left ventricular ejection fraction (LVEF): lower ejection fraction (LEF [n = 29], LVEF <60%) and normal ejection fraction (NEF [n = 64], LVEF >= 60%). Hospitalization rates and echocardiographic parameters were evaluated. Results: The 1-year hospitalization rate for acute cardiovascular events decreased after the therapy initiation in both groups (LEF: 0.36-0.11, p = 0.02 and NEF: 0.43-0.06, p < 0.001). In generalized linear mixed models, LVEF (44 +/- 15%) improved at 1, 2, and 3 years after initiation (53 +/- 18, 55 +/- 17, and 58 +/- 7%; p < 0.05) in the LEF group, whereas, in the NEF group, LVEF (68 +/- 5%) was maintained at 1, 2, and 3 years after initiation (67 +/- 8, 67 +/- 9, and 68 +/- 9%; p > 0.05). Mitral inflow E velocity to tissue Doppler e' ratio was maintained at the same level at 1-3 years after initiation in both groups. Left ventricular mass index (LVMI; 189 +/- 41 g/m(2)) was decreased at 1 (178 +/- 35 g/m(2); p = 0.8), 2 (160 +/- 45 g/m(2); p = 0.008), and 3 (166 +/- 47 g/m(2); p = 0.05) years after initiation in the LEF group, whereas in the NEF group, LVMI (157 +/- 45 g/m(2)) was maintained at 1, 2, and 3 years after initiation (153 +/- 40, 155 +/- 54, and 158 +/- 52 g/m(2); p > 0.05). Conclusion: Hybrid therapy decreased acute cardiovascular events and improved systolic cardiac function in PD patients in the LEF group. (c) 2018 S. Karger AG, Basel