Association of fetuin A,left ventricular function and residual renal function in peritoneal dialysis patients

Objective To investigate the relationship between fetuin A and left ventricular function and their influences on residual renal function(RRF) in peritoneal dialysis patients. Method Eighty patients recently initiating peritoneal dialysis were enrolled into this study and were divided into high fetuin A group and low fetuin A group accordin to the value of serum fetuin A concentration. Hemoglobin, high sensitive C reactive protein(hsCRP), calcium, phosphorus, albumin, lipoproteins and left ventricular myocardial performance index(LV-MPI) were examined. All these patients were followed up for 12 months, to discover the parameters’ differences between two groups and to investigate the association between fetuin A and left ventricular function and RRF. Results At the beginning of the study, there was no difference of hsCRP, calcium, phosphorus, albumin, lipoproteins and LV-MPI, estimated glomerular filtration rate (eGFR) between two groups; After 12 months follow-up, MPI was obviously shorter (P＜0.05) and RRF was obviously higher (P＜0.05) in high fetuin A group than thosein low fetuin A group. Compared with the beginning of the study, LV-MPI was significantly increased and eGFR was significantly decreased after 12 months follow-up (both P＜0.05) in low fetuin A group, but no obviously change of LV-MPI or eGFR was found in high fetuin A group after follow-up. Pearson correlation analysis discovered an obvious negative correlation between fetuin A and MPI (r=-0.680, P＜0.01). Multiple regression analysis indicated that eGFR had positive correlation with fetuin A (B=0.058, t=3.679, P＜0.01) and negative correlations with MPI (B=-0.511, t=-2.903, P=0.007), age(B=-0.144, t=-4.013, P＜0.01). Diabetes was risk factor to loss of RRF (B=-2.031, t=-2.759, P＜0.05). Conclusion Fetuin A has very close relationship with left ventricular function.Decreased serum fetuin A level and decreased left ventricular function are risk factors to the loss of the RRF in ERSD patients.