Effect of peritoneal dialysis and hemodialysis dialysis on myocardial injury

Objective To compare the effects of two dialysis methods, peritoneal dialysis (PD) and hemodialysis (HD) on myocardial injury.Methods From May 2011 to May 2014, 200 patients with end-stage renal disease in Second Hospital Affiliated to Lanzhou University were studied retrospectively. The patients were divided into HD group and PD group according to the dialysis methods. In PD group (100 cases), there were 52 males and 48 females, and dialysis time was 4-19 months (mean 14.2±0.9 months). In HD group (100 cases), there were 48 males and 52 females, and dialysis time was 4-17 months (mean 13.2±1.2 months). All of the patients were tested for myocardial injury markers such as myoglobin, creatine kinase, troponin, B type natriuretic peptide, lactate dehydrogenase and hypersensitivity C reactive protein, and the difference in these indexes was compared between the two groups.Results No dialysis termination, kidney transplantation, loss of access and death were observed in the two groups during the follow-up period. There was no significant difference between the two groups in baseline data and characteristics (P>0.05), but the blood potassium was higher (P<0.05), and the serum CO₂ binding capacity and serum ferritin levels were lower (P<0.05) in the HD group than in the PD group. Baseline adequacy, adequacy of dialysis, and baseline, cardiac structure, and cardiac function were not statistically different between the two groups (P>0.05). In HD group after dialysis, myoglobin, creatine kinase, cardiac troponin B, atrial natriuretic peptide and lactate dehydrogenase were 187 ng/ml, 14.5 ng/ml, 201 ng/L, 245 ng/L, 135 U/L and 10.8 mg/L respectively, and those in PD group were 190 ng/ml, 14.7 ng/ml, 209 ng/L, 278 ng/L, 143 U/L and 10.1 mg/L respectively. During the follow-up period, there was no significant difference in cardiovascular diseases between two groups (P>0.05). Risk factors analysis indicated that troponin, myoglobin, creatine kinase, and B type natriuretic peptide could reflect the renal injury in uremic patients.Conclusions HD and PD have no significant difference in myocardial injury in uremic patients.