Cardiac sympathetic hyperactivity in chronic kidney disease--a comparison between haemodialysis and peritoneal dialysis patients

The effect of renal replacement therapy on cardiac sympathetic function in patients with chronic kidney disease has not yet been completely elucidated. The aim of this study was to evaluate the impact of renal replacement therapy on the activity of cardiac sympathetic nervous system. Thirty-four patients with chronic kidney disease were studied: 14 patients (6 men, mean age 48 ± 11 years) were receiving peritoneal dialysis (PD) and 20 patients (20 men, mean age 52 ± 10 years) were receiving haemodialysis (HD). Patients with diabetes and heart failure were excluded from the study. All patients underwent resting gated myocardial perfusion and ¹²³I-mIBG myocardial scintigraphy from which early and late heart to mediastinum ratios (HRM) and myocardial washout rate (WR) values were calculated. PD and HD patients did not differ with respect to left ventricular ejection fraction (52 ± 9% vs. 57 ± 7%) and summed rest score (3.8 ± 2.4 vs. 3.5 ± 0.3). Similarly, early (1.89 ± 0.23 vs. 1.87 ± 0.27) and late (1.76 ± 0.47 vs. 1.74 ± 0.25) HMR, and washout rate (35.5 ± 15.8% vs. 31.3 ± 9.4%) were not significantly different between the two groups of patients. These results suggest that the applied method of renal replacement therapy has no significant influence on global activity of cardiac sympathetic nervous system.