INTRODUCTION
There has been a rise in the incidence and prevalence of end-stage renal disease (ESRD) in recent years. 1 Cardiovascular diseases (CVD) are the main causes of death in patients undergoing dialysis. 2 The role of the traditional risk factors (e.g., arterial hypertension, diabetes mellitus) is important in the pathogenesis of CVD, however it can not be fully explained with these risk factors. 3
Right ventricular (RV) dysfunction is one of the major predictors of mortality and heart failure in this patient group. It has been shown that patients undergoing hemodialysis (HD), which is usually carried out via a surgically created arteriovenous fistula (AVF), have an increased risk for pulmonary hypertension and poorer right ventricular function compared with healthy controls. 4,5 Chronic pressure/volume overload of the RV determined by AVF leads to a progressive rise in pulmonary pressures and deteriorates RV function.6 However, several other pathogenic mechanisms and risk factors which are frequently observed in ESRD patients, can be responsible for RV dysfunction.
In our previous study that we compared peritoneal dialysis (PD) patients and healthy controls in terms of echocardiographic RV function, we showed that RV function, assessed by conventional echocardiography in PD patients, did not differ from healthy controls. 7However, the literature includes a limited number of studies regarding the comparison of the effects of different dialysis modalities on RV function in ESRD patients. The aim of the current study was to elucidate the impact of both long-term PD and HD therapy via AVF, on RV function in ESRD patients with preserved left ventricular (LV) function.