Risk factors for cardiovascular disease in patients undergoing peritoneal dialysis.
Patients on peritoneal dialysis (PD) are at high cardiovascular risk. Although some risk factors are unmodifiable (for example, age, sex, genetics), others are exacerbated in the unfriendly uremic milieu (inflammation, oxidative stress, mineral disturbances) or contribute per se to kidney disease and cardiovascular progression (diabetes mellitus, hypertension). Moreover, several factors associated with PD therapy may both increase (by altered lipid profile, hyperinsulinemia, and formation of advanced glycation end-products) and decrease (by better blood pressure control and anemia management) cardiovascular risk. The present review discusses recent findings and therapy trends in cardiovascular research on the PD population, with emphasis on the roles of inflammation, insulin resistance, homocysteinemia, dyslipidemia, vascular calcification, and genetics/epigenetics.
García-López
Elvia
E
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Carrero
Juan J
JJ
Suliman
Mohamed E
ME
Lindholm
Bengt
B
Stenvinkel
Peter
P
D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D015314:Dialysis Solutions / Q000494:pharmacology; D018450:Disease Progression; D050171:Dyslipidemias / Q000209:etiology; D006711:Homocystine / Q000097:blood; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D007249:Inflammation; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D016019:Survival Analysis
D015314:Dialysis Solutions; D006711:Homocystine