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Multicenter Study
. 2025 Dec;47(1):2497493.
doi: 10.1080/0886022X.2025.2497493. Epub 2025 May 19.

The combination of left ventricular ejection fraction and end-diastolic diameter and outcomes in peritoneal dialysis patients: a multicenter retrospective study

Jiayin You  1 , Ning Su  2 , Xiaoran Feng  3 , Fenfen Peng  4 , Qingdong Xu  5 , Xiaojiang Zhan  6 , Yueqiang Wen  7 , Xiaoyang Wang  8 , Na Tian  9 , Xianfeng Wu  1 , Niansong Wang  1
Affiliations
Multicenter Study

The combination of left ventricular ejection fraction and end-diastolic diameter and outcomes in peritoneal dialysis patients: a multicenter retrospective study

Jiayin You et al. Ren Fail. 2025 Dec.

Abstract

End-stage renal disease (ESRD) is often complicated by left ventricular dysfunction, which is associated with a poor prognosis. This study aims to investigate the association between baseline left ventricular ejection fraction (LVEF) plus left ventricular end-diastolic diameter (LVEDD) with outcomes in peritoneal dialysis (PD) patients. In this multicenter retrospective study, 1,511 incident Chinese patients on PD between 1 January 2005 and 31 December 2021 were enrolled. Restricted cubic splines (RCS) were used to explore the non-linear associations between LVEF+LVEDD and the risk of mortality. Parametric models for interval-censored survival-time data (stintreg) were used to examine the association between LVEF+LVEDD quartiles and the outcomes. During 6,451.11 person-years of follow-up [median 4.81 (IQR 3.61-6.81) years], 247 (17.8%) patients died, including 88 cardiovascular deaths. RCS showed a U-shaped association between LVEF+LVEDD and the risks of all-cause and CV mortality. According to the quartiles, the optimal range of LVEF+LVEDD associated with the lowest risk of all-cause and CV mortality was 103-107, which was set as the reference range. Both higher (≥115) and lower (<103) levels of LVEF+LVEDD were associated with increased risks of all-cause mortality (hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.58-3.07; HR 1.68, 95% CI 1.19-2.36) and cardiovascular mortality (HR 2.51, 95% CI 1.33-4.75; HR 1.86, 95% CI 0.96-3.61). Low and high levels of baseline LVEF+LVEDD were associated with increased risks of all-cause and cardiovascular mortality in PD patients.

Keywords: Left ventricular ejection fraction; left ventricular end-diastolic diameter; mortality; peritoneal dialysis.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow-chart of eligible and ineligible patients. The numbers of potential and eligible patients were shown on the left side, and the reasons for in ineligibility and the numbers of ineligible patients were shown on the right side. CAPD, continuous ambulatory peritoneal dialysis.
Figure 2.
Figure 2.
Cumulative all-cause and cardiovascular mortality according to EF+LVEDD quartiles. p Value for log-rank test were 0.028 and 0.016, respectively.
Figure 3.
Figure 3.
Cumulative cardiovascular event according to EF+LVEDD quartiles. p Value for log-rank test was 0.937.
Figure 4.
Figure 4.
Association between EF+LVEDD and all-cause and cardiovascular mortality (p for non-linear trend were < 0.001 and 0.016, respectively) based on model 3. The cutoff were 102 and 101.
Figure 5.
Figure 5.
Association between EF+LVEDD and cardiovascular event based on model 3 (p for non-linear trend = 0.037). The cutoff was 104.
See this image and copyright information in PMC

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