The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

Left ventricular (LV) diastolic function was found to be a significant predictor of cardiovascular events and general mortality in dialysis. Studies have indicated that dialysate calcium concentrations were significantly associated with cardiac function. However, the relationship between low calcium dialysate and LV diastolic function has not been clear. The aim of this study was to investigate the influence of low calcium dialysate on cardiac function in peritoneal dialysis (PD) patients. A total of 60 PD patients were enrolled in this study, with a calcium content of the PD solution of 1.25mmol/L in 30 patients (low-calcium group) and 1.75mmol/L in 30 patients (standard-calcium group). Standard M-mode and two-dimensional ultrasound measurements were applied to detect the cardiac function. After 12-month follow-up, we found no significant difference in blood pressure, calcium, phosphorus, parathyroid hormone (PTH), etc., between the two groups. Residual renal function (RRF), which is associated with LV cardiac function, was significantly decreased in the standard-calcium group compared with the low-calcium group (5.64 +/- 3.23 vs. 9.38 +/- 3.17, p=.001). Compared with the low-calcium group, E-max (peak early diastolic velocity) and A(max) (peak late diastolic velocity) were significantly decreased (p<.05), whereas myocardial performance index (MPI) was obviously increased in standard-calcium group (9.69 +/- 2.71 vs. 7.75 +/- 0.93, p<.05). In conclusion, our data suggest that low calcium dialysate treatment is significantly associated with better LV diastolic function.