Abstract: 【Abstract】Objective To investigate the effect of peritoneal dialysis adequacy on cardiac structure and function in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods Eighty-six patients treated with CAPD for at least 3 months in our department were enrolled in this study. Patients were divided into two groups according to the adequacy of peritoneal dialysis: group A (n=44), urea clearance index (Kt/V total) ≥ 1.7 and creatinine clearance weekly (WCcr total) ≥50L/(w•1.73m2), and group B (n=42), urea clearance index (Kt/V total) ＜1.7 and creatinine clearance weekly (WCcr total) ＜50L/(w•1.73m2). Forty-four healthy individuals were recruited as controls (group C). Blood pressure was measured, and blood BUN, Scr, Ca, P, PTH, Hb and Alb were also measured in all patients. IVST, LVPWT, LAD, LVDd, LVDs, EF and E/A were determined by echocardiography. Kt/V total, Kt/V renal, WCcr total and rGFR were calculated. Results ① LVMI, IVST, LVPWT and LAD were significantly lower in group A than in group B (139.8±29.7 g/m2 vs. 178.4±30.5 g/m2, F=1.053, P =0.003 for LVMI; 11.9±2.01 mm vs. 13.5±1.7 mm, F=1.396, P =0.012 for IVST; 11.3±2.1 mm vs. 13.0±1.8 mm, F=1.358, P =0.011 for LVPWT; 34.2±5.6 mm vs. 40.0±6.3 mm, F=1.258, P= 0.011 for LAD). EF was significantly higher in group A than in group B (61.4±5.6% vs. 57.8±7.4% F=1.754, P=0.041). There was no significant difference in diastolic function between the two groups (F=1.778, P=0.821). ② Group A had lower levels of BUN, Scr and PTH (P＜0.01), lower SBP and DBP (P＜0.05), higher Alb and Hb (P＜0.05), higher Kt/V values of residual renal function and rGFR (P＜0.01) as compared with whose in group B. The Kt/v value of residual renal function was 35% of total Kt/V in group A, and was 12% of total Kt/V in group B (P＜0.01). ③ Cardiac structure and function were correlated with uremic toxins, malnutrition, anemia, hypertension and residual renal function. Conclusions There is a close relationship between peritoneal dialysis adequacy and cardiac structure and function. Cardiac structure and function can be improved by maintaining a rational peritoneal dialysis adequacy. Protecting the residual renal function and maintaining the dialysis adequacy can reduce the incidence of cardiovascular disease and the mortality in CAPD patients.

Key words: perioneal dialysis, dialysis adequacy, cardiac structure and function