Vascular stiffness in incident peritoneal dialysis patients over time
| Autor: | Adeera Levin, Mila Tang, Monica Beaulieu, Ognjenka Djurdjev, Paul Taylor, Alexandra Romann, Mhairi K. Sigrist, G. Chiarelli, Suneet Singh |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class medicine.medical_treatment Peritoneal dialysis Vascular Stiffness Internal medicine medicine Humans Prospective Studies Vascular Calcification Prospective cohort study Adverse effect Pulse wave velocity Aged business.industry General Medicine Middle Aged medicine.disease Phosphate binder Logistic Models Parathyroid Hormone Nephrology Pulsatile Flow Cohort cardiovascular system Cardiology Female Hemodialysis business Peritoneal Dialysis Calcification |
| Zdroj: | Clinical Nephrology. 78:254-262 |
| ISSN: | 0301-0430 |
| Popis: | OBJECTIVE Vascular stiffness is prevalent in end-stage renal disease patients and predicts adverse events. This study describes the prevalence of vascular stiffness and its associated factors in a cohort of incident peritoneal dialysis (PD) patients. METHODS In a prospective observational study of 50 patients, carotid-femoral pulse wave velocity (PWV) were conducted at baseline, 3, 6 and 12 months after initiation of PD. Aortic calcification scores (ACS) were derived using plain lateral abdominal films. We examined the association of significant changes in PWV (defined as 1 m/s or 15% change from baseline) over 6 months in conjunction with demographic and clinical data. RESULTS The mean age was 58 years, 67% were male, and 48% were Caucasian. One third was diabetic, and 23% had pre-existing cardiovascular disease. Median eGFR was 8.7 ml/ min. ACS was strongly correlated with PWV (r = 0.62, p < 0.0001). Over 6 months, 42% demonstrated significant increases, while 23% demonstrated decreases in their PWV. Factors shown to be associated with increasing PWV were Caucasian race (OR = 4.50; CI: 0.97 - 20.83), higher phosphate (OR = 8.36; CI: 1.10 - 63.51) and a lower baseline PWV (OR = 0.67; CI: 0.45 - 0.99). Decrease in PWV was associated with the absence of calcium based phosphate binder usage (OR = 0.11; CI: 0.02 - 0.73). Changes in weight and PWV at 12 months were significantly correlated (p = 0.007, r = 0.57). CONCLUSION In this group of incident PD patients, we demonstrate a lower prevalence of vascular calcification than in hemodialysis patients, a correlation of calcification with PWV, and an important finding that PWV can change in either direction over a short period of time, which are associated with modifiable risk factors. |
| Databáze: | OpenAIRE |
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