OBJECTIVES: Scientific literature indicates that the risk of coronary heart disease morbidity and death among peritoneal dialysis patients exceeds risk observed in non-renal patients. The aims of this study were to establish the independent predictors associated with increased risk of coronary heart disease in peritoneal dialysis patients without diabetic nephropathy. MATERIALS AND METHODS: A number of 116 end-stage renal disease patients without diabetic nephropathy undergoing peritoneal dialysis were evaluated for coronary heart disease and predictive risk factors were investigated and identified. Also intima-media thickness measurements, as an early sign of atherosclerosis, were analyzed in a subset of patients in correlation with a number of traditional and non-traditional cardiovascular risk factors. RESULTS: The study sample was found to be characterized by a high prevalence of traditional risk factors: hypertension (95.7%), dyslipidemia (93.1%) and metabolic syndrome (58.6%), but also of dialysis-related risk factors: inflammation (82.8%) and anemia (55.2%). Independent variables found to be associated in regression analysis with coronary heart disease were: age, smoking status, nephroangiosclerosis, albumin, C-reactive protein and iPTH levels. Intima-media thickness was significantly higher in patients with coronary heart disease, values greater than 0.89 mm being associated with increased risks for coronary heart disease, acute coronary syndrome and cardiovascular death. CONCLUSIONS: The prevalence of traditional cardiovascular risk factors in these peritoneal dialysis patients is extremely high, but there are also some other factors involved, especially malnutrition and inflammation. Age higher than 55 years, smoking, albumin less than 3.5 g/dl, iPTH less than 150 pg/ml and nephroangiosclerosis were associated with highest odds ratio for coronary heart disease. An increasing CRP levels was associated with an increasing gradient for coronary heart disease risk.
OBJECTIVES: Scientific literature indicates that the risk of coronary heart disease morbidity and death among peritoneal dialysis patients exceeds risk observed in non-renal patients. The aims of this study were to establish the independent predictors associated with increased risk of coronary heart disease in peritoneal dialysis patients without diabetic nephropathy. MATERIALS AND METHODS: A number of 116 end-stage renal diseasepatients without diabetic nephropathy undergoing peritoneal dialysis were evaluated for coronary heart disease and predictive risk factors were investigated and identified. Also intima-media thickness measurements, as an early sign of atherosclerosis, were analyzed in a subset of patients in correlation with a number of traditional and non-traditional cardiovascular risk factors. RESULTS: The study sample was found to be characterized by a high prevalence of traditional risk factors: hypertension (95.7%), dyslipidemia (93.1%) and metabolic syndrome (58.6%), but also of dialysis-related risk factors: inflammation (82.8%) and anemia (55.2%). Independent variables found to be associated in regression analysis with coronary heart disease were: age, smoking status, nephroangiosclerosis, albumin, C-reactive protein and iPTH levels. Intima-media thickness was significantly higher in patients with coronary heart disease, values greater than 0.89 mm being associated with increased risks for coronary heart disease, acute coronary syndrome and cardiovascular death. CONCLUSIONS: The prevalence of traditional cardiovascular risk factors in these peritoneal dialysis patients is extremely high, but there are also some other factors involved, especially malnutrition and inflammation. Age higher than 55 years, smoking, albumin less than 3.5 g/dl, iPTH less than 150 pg/ml and nephroangiosclerosis were associated with highest odds ratio for coronary heart disease. An increasing CRP levels was associated with an increasing gradient for coronary heart disease risk.
Authors: Martin Wagner; David Ansell; David M Kent; John L Griffith; David Naimark; Christoph Wanner; Navdeep Tangri Journal: Am J Kidney Dis Date: 2011-04-12 Impact factor: 8.860
Authors: E Jarauta; R Mateo-Gallego; R Gilabert; N Plana; M Junyent; E de Groot; A Cenarro; L Masana; E Ros; F Civeira Journal: Nutr Metab Cardiovasc Dis Date: 2010-12-31 Impact factor: 4.222
Authors: A S Levey; J A Beto; B E Coronado; G Eknoyan; R N Foley; B L Kasiske; M J Klag; L U Mailloux; C L Manske; K B Meyer; P S Parfrey; M A Pfeffer; N K Wenger; P W Wilson; J T Wright Journal: Am J Kidney Dis Date: 1998-11 Impact factor: 8.860
Authors: J Craig Longenecker; Josef Coresh; Neil R Powe; Andrew S Levey; Nancy E Fink; Alice Martin; Michael J Klag Journal: J Am Soc Nephrol Date: 2002-07 Impact factor: 10.121
Authors: Vasilios G Athyros; Apostolos I Hatzitolios; Asterios Karagiannis; Christos Savopoulos; Niki Katsiki; Konstantinos Tziomalos; Aikaterini Papagianni; Anna Kakafika; Thomas D Gossios; Dimitri P Mikhailidis Journal: Arch Med Sci Date: 2011-12-30 Impact factor: 3.318