Abstract
BACKGROUND: Early detection of the changes of left atrial (LA) structure and function in uremic patients after peritoneal dialysis (PD) treatment facilitates clinical evaluation and early intervention. This study aimed to construct a model using the four-dimensional automatic LA quantification technique (4D-LAQ) to evaluate the impact of PD on the left atrium of patients with chronic kidney disease stage 5 (CKD-5). METHODS: This study included 109 patients with CKD-5 and 38 age- and gender-matched healthy volunteers. The required clinical and ultrasound parameters were collected from all participants. Continuous variables were expressed as mean ± standard deviation or median (interquartile range), whereas categorical variables were presented as frequency (percentage). Independent risk factors associated with PD treatment were identified using binary logistic regression analysis, which was also employed to construct a predictive model. The performance of this model was assessed using receiver operating characteristic (ROC) curve analysis, with the area under the curve (AUC) and its confidence interval (CI) calculated to quantify predictive accuracy. A P value <0.05 was considered statistically significant. RESULTS: (I) Compared with group n, the LA volume of CKD-5 patients was higher. (II) Compared with the PD group, maximum left atrial volume (LAVmax), left atrial pre-atrial contraction volume (LAVpreA), left atrial maximum volume index (LAVImax), and left atrial ejection volume (LAEV) in the CK5 stage (N-PD) group increased (P<0.05). (III) 4D-LAQ can be used to construct a risk model for predicting adverse cardiovascular events, for which LAVImax is an independent risk factor. (IV) LAVImax, New York Heart Association (NYHA) heart function classification ≥ II, and E/e' ≥14 combined had the largest AUC. CONCLUSIONS: The 4D-LAQ technique can be used to evaluate the effect of PD on the left atrium of CKD-5 patients, and can predict the probability of adverse cardiovascular events in CKD-5 patients after PD.