Comparison of Left Ventricular Diastolic Function Parameters between Patients with Unplanned and Planned Hemodialysis Initiation: A Cross-Sectional Study

Abstract

Despite the increasing number of dialysis patients, there is still no clear consensus regarding when a permanent access device should be prepared and renal replacement treatment should be undertaken. The purpose of this study was to evaluate left ventricular diastolic function at the start of dialysis between patients in a planned or unplanned manner according to the 2016 recommendations of the American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI). We designed a single-center, cross-sectional study to use echocardiography to evaluate and compare left ventricular diastolic function at the onset of dialysis between patients in planned and unplanned groups. A total of 21 patients were included in our analysis (11 initiated dialysis in a planned manner and 10 did so in an unplanned manner). E/A and E/E′ were significantly high in the unplanned dialysis initiation group (p = 0.048 and p = 0.003, respectively). Furthermore, the number of patients with an E/E′ ratio of >14 and tricuspid regurgitation velocity of >2.8 was also significantly high in the unplanned dialysis initiation group (80% vs. 18%; p = 0.009, 40% vs. 0%; p = 0.035, respectively). According to the American Society of Echocardiography and the European Association of Cardiovascular Imaging Recommendation in 2016, the number of patients with left ventricular diastolic dysfunction was significantly high in the unplanned dialysis initiation group (80% vs. 18%; p = 0.009). The current study demonstrated that left ventricular diastolic dysfunction is more apparent in incident dialysis patients in an unplanned manner. Our findings suggest that the assessment of left ventricular diastolic function by echocardiography may be an indication of when to create a permanent access device and initiate dialysis.