Evaluation of predictors of mortality and coronary events in patients on peritoneal dialysis

• Grant number: 23/00160-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2023
• End date: March 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Silméia Garcia Zanati Bazan
• Grantee: Andreiza Mara Gomes Lana
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Introduction: Patients with chronic kidney disease (CKD) are a major public health issue, due to its high incidence and treatment cost. In this group, the general mortality is about 20% per year, mainly from cardiovascular ethiology. Among the cardiovascular risk factos, there's vascular calcification, evaluated through coronary artery calcium score (CAC). Such exam is not however easy to perform, being the echocardiogram a much more feasible exam. In CKD under substitutive kidney therapy, the left atrium size measured by echocardiogram was associated to the occurrence of silent ischaemia. In the literature, there are few evidence relating left atrium size with coronary calcium score or cardiovascular events and mortality, specialy when under peritoneal dialysis. Objective: To evaluate mortality and cardiovascular events predictors in patients under peritoneal dialysis, focusing on the sensibility and specificity of echocardiographic variables when compared to the CAC method and to analyse the relation between left atrium size measured by echocardiogram and other variables assessed. Casuistic and methods: Transversal study, in CKD patients under peritoneal dialysis in the Dialysis Unit at the Clinics Hospital, Botucatu Medical School - UNESP. The sample size of 44 patients will be enough to show a difference of 60% to 20% in the frequency of outcomes, considering an alpha error of 5% and a beta error of 20%. The follow-up period will be of 2.5 to 3.5 years. It will be assessed demographic and clinical data, biochemical analysis, weekly peritoneal Kt/V and residual kidney function, coronary calcium score, echocardiographic analysis, arterial stiffness evaluation, and hidration status. Expected results: In this study, we expect to find during the follow-up a positive relation between left atrium and the presence of cardiovascular events and mortality in CKD patients under peritoneal dialysis.