Color Doppler Ultrasonography Evaluation Of Superior Mesenteric Artery Hemodynamics Changes In Peritoneal Dialysis

Objective:To investigate the changes of hemodynamic parameters of superior mesenteric artery(SMA) during peritoneal dialysis(PD) and their relationship with peritoneal ultrafiltration function.Methods:Color Doppler was used to examine SMA hemodynamic parameters in 100 subjects, which were divided into 3 groups according to treatment. Group PD contained 40 uremic patients with PD, Group NPD contained 30 uremic patients without PD.Group C contained 30 healthy subjects.Then Group PD was divided into 2 groups according peritoneal dialysis time.Group PDâ… contains 20 patients with PD and the time of PD was less than one year. Group PDâ…¡contains 20 patients with PD and the time of PD was more than one year.Results:1) Grouped according to treatment:(1)The peak systolic velocity (PSV) and diameter (D) were not statistical different among three groups(P>0.05). (2)The resistance index (RI) and pulsatility index (PI) decreased in PD group compared with the other two groups(P<0.05), but no difference was found between NPD group and C group (P>0.05).(3)The end-diastolic velocity (EDV), time-averaged velocity (TAVM) and blood flow (Q) were higher in PD group than those in NPD group and C group (P<0.05). No difference of EDV, TAVM and Q was found between the C group and NPD group(T>0.05)(4)PI and RI were negatively correlated with PD time (r=-0.890, P<0.01. r=-0.436, P<0.01).2) Grouped according to peritoneal dialysis time:(1)The peak systolic velocity(PSV) and diameter(D) were no difference among the four groups(P>0.05); (2)The end-diastolic velocity (EDV),time-averaged velocity(TAVM) and blood flow(Q)were higher in Group PDâ…¡than those in Group PDâ… and Group C and NPD (P<0.01). But there were no differences on EDV, TAVM and Q between the Group C,Group NPDand Group PDâ… (P>0.05). The Resistance index RI and Pulsatility index Pâ… were decreased in Group PDâ…¡compared with Group PDâ… ,Group NPDand Group C (P<0.01).There were no differences between the Group PDâ… ,Group NPD and Group C (P>0.05). (3)The peritoneal ultrafiltration volume was lower in Group PDâ…¡vs in Group PDâ… (P<0.01).(4) Peritoneal ultrafiltration volume was decreased along with the time of peritoneal dialysis,and correlated negatively of peritoneal dialysis time(r=-0.599, P<0.01). Although the peritoneal ultrafiltration volume was correlated positively with RI,PI(r=0.677,P<0.01,r=0.554,P<0.01).Conclusions:Peritoneal dialysis cause the SMA hemodynamic changes and peritoneal ultrafiltration dysfunction. Color Doppler ultrasound can evaluate those changes non-invasively,and the decrease of RI,PI can intimate the damage of peritoneal ultrafiltration function.