Factors associated with increased pulse wave velocity in peritoneal dialysis patients

• Authors: Paweł Stróżecki , Rafał Donderski , Magdalena Grajewska , Elżbieta Marcinkowska , Michał Kozłowski , Joanna Pollak , Grażyna Odrowąż-Sypniewska , Jacek Manitius
• Languages of publication: EN

Abstracts

EN

Elevated pulse wave velocity (PWV) reflects increased arterial stiffness. Several studies have investigated PWV in peritoneal dialysis (PD) patients, but direct comparisons with healthy controls were not done. The potential influence of peritoneal transport characteristics on arterial stiffness in PD patients was suggested in recent studies. The aims of this study were to compare PWV in PD patients and healthy volunteers, and to investigate factors associated with increased PWV. The carotid-femoral PWV was measured in 28 PD patients and 28 healthy controls, matched for age and gender. A peritoneal equilibration test (PET) was performed in all PD patients. Based on the PET, patients were classified as: high transporters (H) (n=8), high-average (HA) (n=12), low-average (LA) (n=6), and low transporters (L) (n=2). Six of the PD patients were diabetic. PWV was significantly higher in the PD patients than in the controls (9,9±2,4 vs. 8,0±0,9; p=0,0004). In the PD group, PWV was higher in H/HA than in L/LA patients (10,4 ± 2,5 vs. 8,6 ± 1,0; p=0,008), but all the diabetic patients were in the H/HA group. PWV was significantly higher in diabetic than in non-diabetic PD patients (12,8 ± 2,0 vs. 9,1 ± 1,7; p=0,004). In the PD patients, significant positive correlations were found between PWV and: age, pulse pressure, Kt/V, and duration of PD therapy. In conclusion, the carotid-femoral PWV is elevated in peritoneal dialysis patients. Increased PWV in PD patients is associated with age, diabetic status, and longer duration of PD therapy, but not with this type of peritoneal transport.

Keywords

EN

Arterial stiffness; Diabetes; Peritoneal dialysis; Peritoneal equilibration test; Peritoneal transport; Pulse wave velocity

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 3
• Pages: 381-386

Dates

published

1 - 6 - 2010

online

9 - 4 - 2010

Contributors

author

Paweł Stróżecki

• Department of Nephrology, Hypertension and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Rafał Donderski

• Department of Nephrology, Hypertension and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Magdalena Grajewska

• Department of Nephrology, Hypertension and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Elżbieta Marcinkowska

• Department of Nephrology, Hypertension and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Michał Kozłowski

• Department of Nephrology, Hypertension and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Joanna Pollak

• Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Grażyna Odrowąż-Sypniewska

• Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

author

Jacek Manitius

• Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland

References

• [1] Blacher J., Asmar R., Djane S., London G.M., Safar M.E., Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients, Hypertension, 1999, 33, 1111–1117 [Crossref]
• [2] Blacher J., Guerin A.P., Pannier B., Marchais S.J., Safar M.E., London G.M., Impact of aortic stiffness on survival in end-stage renal disease, Circulation, 1999, 99, 2434–2439 [Crossref]
• [3] Cruickshank K., Rista L., Anderson S.G., Wright J.S., Dunn G., Golsing R.G., Aortic pulse wave velocity and its relationship to mortality in diabetes and glucose intolerance. An intergrated index of vascular function? Circulation, 2002, 106, 2085–2090 http://dx.doi.org/10.1161/01.CIR.0000033824.02722.F7[Crossref]
• [4] Hansen T.W., Staessen J.A., Torp-Pedersen C., Rasmussen S., Thijs L., Ibsen H., et al., Prognostic value of aortic pulse wave velocity as index of arterial stiffness in general population, Circulation, 2006, 113, 664–670 http://dx.doi.org/10.1161/CIRCULATIONAHA.105.579342[Crossref]
• [5] Hermans M.M., Brandenburg V., Kettler M., Kooman J.P., van der Sande F.M., Gladziwa U., et al., Study on the relationship of serum fetiun-A concentration with aortic stiffness in patients on dialysis, Nephrol. Dial. Transplant, 2006, 21, 1293–1299 http://dx.doi.org/10.1093/ndt/gfk045[Crossref]
• [6] Covic A., Goldsmith D.A., Florea L., Gusbeth-Tatomir P., Covic M., The influence of dialysis modality on arterial stiffness, pulse wave reflections, and vasomotor tone. Perit. Dial. Int., 2004, 34, 365–372
• [7] Churchill D.N., Thorpe K.E., Nolph K.D., Keshaviah P.R., Oreopoulos D.G., Page D., Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients, J. Am. Soc. Nephrol., 1998, 9, 1285–1292
• [8] Chung S.H., Chu W.S., Lee H.A., Kim Y.H., Lee I.S., Lindholm B., et al., Peritoneal transport characteristics, comorbid diseases and survival in CAPD patients, Perit. Dial. Int., 2000, 20, 541–547
• [9] Brimble S., Walker M., Margetts P., Kundhal K., Rabbat C., Meta-analysis: peritoneal membrane transport, mortality, and technique failure in peritoneal dialysis, J. Am. Soc. Nephrol., 2006, 17, 2591–2598 http://dx.doi.org/10.1681/ASN.2006030194[Crossref]
• [10] Zhe X., Tian X., Gou L., Gu Y., Chen H., Tang L., et al., Association between arterial stiffness and peritoneal fluid kinetics, Am. J. Nephrol., 2008, 28, 128–132 http://dx.doi.org/10.1159/000109981[WoS][Crossref]
• [11] Huang W.H., Chen K.H., Hsu C.W., Chen Y.C., Hung C.C., Huang J.Y., et al., Residual renal function - one of the factors associated with arterial stiffness in peritoneal dialysis patients, Blood. Purif., 2008, 26, 133–137 http://dx.doi.org/10.1159/000113013[WoS][Crossref]
• [12] Twardowski Z.J., Nolph K.D., Khanna R., Prowant B.F., Ryan L.P., Moore H.L., Peritoneal equilibration test, Perit. Dial. Int., 1987, 7, 138–147
• [13] O’Rourke M.F., Staessen J.A., Vlachopoulos C., Duprez D., Plante G.E., Clinical applications of arterial stiffness; definitions and reference values, Am. J. Hypertens., 2002, 15, 426–444 http://dx.doi.org/10.1016/S0895-7061(01)02319-6[Crossref]
• [14] Zhe X.W., Zeng J., Tian X.K., Chen W., Gu Y., Cheng L.T., et al., Pulse wave velocity is associated with metabolic syndrome components in CAPD patients, Am. J. Nephrol., 2008, 28, 641–646 http://dx.doi.org/10.1159/000117813[WoS][Crossref]
• [15] Bahous S.A., Stephan A., Barakat W., Blacher J., Asmar R., Safar M.E., Aortic pulse wave velocity in renal transplant recipients, Kidney. Int., 2004, 66, 1486–1492 http://dx.doi.org/10.1111/j.1523-1755.2004.00912.x[Crossref]
• [16] Huang W.H., Hsu C.W., Chen Y.C., Hung C.C., Huang J.Y., Lin J.L., et al., Angiotension II receptor antagonist supplementetion is associated with arterial stiffness: insight from a retrospective study in 116 peritoneal dialysis patients, Ren. Fail., 2007, 29, 834–838
• [17] Konings C.J., Dammers R., Rensma P.L., Koomans J.P., Hoeks A.P., Kornet L., et al., Arterial wall properties in patients with renal failure. Am. J. Kidney. Dis., 2002, 39, 1206–1212 http://dx.doi.org/10.1053/ajkd.2002.33392[Crossref]
• [18] Sigrist M., Bungay P., Tall M.W., McIntre C.W., Vascular calcifications and cardiovascular function in chronic kidney disease, Nephrol. Dial. Transplant, 2006, 21, 707–714 http://dx.doi.org/10.1093/ndt/gfi236[Crossref]
• [19] Stompór T., Rajzer M., Sułowicz W., Dembińska-Kieć A., Janda K., Kawecka-Jaszcz K., et al., An association between aortic pulse wave velocity, blood pressure and chronic inflammation in ESRD patients on peritoneal dialysis. Int. J. Artif. Organs, 2003, 26, 188–195
• [20] Covic A., Gusbeth-Tatomir P., Goldsmith D.J., Arterial stiffness in renal patients: an update, Am. J. Kidney. Dis., 2005, 45, 965–977 http://dx.doi.org/10.1053/j.ajkd.2005.02.026[Crossref]
• [21] Winkelmayer W.C., Glynn R.J., Mittleman M.A., Levin R., Pliskin J.S., Avorn J., Comparing mortality of eldery patients on hemodialysis versus peritoneal dialysis: a propensity score approach, J. Am. Soc. Nephrol., 2002, 13, 2353–2362 http://dx.doi.org/10.1097/01.ASN.0000025785.41314.76[Crossref]
• [22] Stack A.G., Molony D.A., Rahman N.S., Dosekun A., Murthy D., Impact of dialysis modality on survival of new ESRD patients with congestive heart failure in the United States, Kidney. Int., 2003, 64, 1071–1079 http://dx.doi.org/10.1046/j.1523-1755.2003.00165.x[Crossref]
• [23] Ganesh S.K., Hulbert-Shearon T., Port F.K., Eagle K., Stack A.G., Mortality differences by dialysis modality among incident ESRD patients with and without coronary artery disease. J. Am. Soc. Nephrol., 2003, 14, 415–424 http://dx.doi.org/10.1097/01.ASN.0000043140.23422.4F[Crossref]
• [24] Sezer S., Tutal E., Arat Z., Akçay A., Çelik H., Özdemir N., Haberal M., Peritoneal transport status influence on atherosclerosis / inflammation in CAPD patients, J. Ren. Nutr., 2005, 15, 427–434 http://dx.doi.org/10.1053/j.jrn.2005.07.007[Crossref]
• [25] Stróżecki P., Donderski R., Grajewska M., Marcinkowska E., Kozłowski M., Manitius J., Does type of peritoneal transport influence arterial stiffness in peritoneal dialysis patients? ASN Renal Week, 31.10–05.11.2007, San Francisco, USA - Abstract SU-PO239
• [26] Aoun S., Blacher J., Safar M.E., Mourad J.J., Diabetes mellitus and renal failure: effects on large artery stiffness, J. Hum. Hypertens., 2001, 15, 639–700 http://dx.doi.org/10.1038/sj.jhh.1001253[Crossref]
• [27] Salomaa V., Riley W., Kark J., Nardo C., Folsom A., Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentration are associated with arterial stiffness indexes. The ARIC Study. Circulation, 1995, 91, 1432–1443 [Crossref]
• [28] Davies S.J., Phillips L., Naish P.F., Russell G.I., Peritoneal glucose transport exposure and changes in membrane solute transport with time of peritoneal dialysis, J. Am. Soc. Nephrol., 2001, 12, 1046–1051
• [29] Fusshöller A., zur Nieden S., Grabensee B., Plum J., Peritoneal fluid and solute transport: influence of treatment time, peritoneal dialysis modality and peritonitis incidence, J. Am. Soc. Nephrol., 2002, 13, 1055–1060
• [30] Stompór T., Pasowicz M., Sułowicz W., Dembińska-Kieć A., Janda K., Wójcik K., et al., An association between coronary artery calcification score, lipid profile and selected marker of chronic inflammation in ESRD patients treated with peritoneal dialysis, Am. J. Kidney. Dis., 2003, 41, 203–211 http://dx.doi.org/10.1053/ajkd.2003.50005[Crossref]

Identifiers

DOI

10.2478/s11536-010-0014-9