Association between arterial stiffness and peritoneal fluid kinetics.
BACKGROUND
A high peritoneal transport status in continuous ambulatory peritoneal dialysis (CAPD) patients is associated with a markedly increased morbidity and mortality. While the causes are as yet unknown, overall the proportion of deaths due to cardiovascular disease is estimated at 40-50% among dialysis patients. Arterial stiffness has been established as a cardiovascular risk factor, while the links between peritoneal transport status and aortic stiffness have not yet been investigated.


METHODS
We included 65 prevalent CAPD patients (24 males/41 females) from our center in a cross-sectional study. Arterial stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral pulse wave velocity (C-F PWV). The patients' peritoneal fluid transport was assessed by kinetic modeling. The patients' peritoneal small solute transport rate was assessed by D/P(cr) at 4 h. Extracellular water to total body water (E/T) ratio was assessed by means of bioimpedance analysis. C-reactive protein was also measured.


RESULTS
C-F PWV was positively correlated with patients' age (r = 0.489, p < 0.01), diabetic status (r = 0.327, p < 0.01), peritoneal fluid absorption rate (Ke; r = 0.251, p < 0.05), PP (r = 0.483, p < 0.01), and E/T (r = 0.517, p < 0.01). Multivariate regression analysis showed that C-F PWV was independently related to E/T (p < 0.01), PP (p < 0.01), age (p < 0.05), and Ke (p < 0.05).


CONCLUSIONS
Peritoneal fluid transport (Ke), as well as E/T, age and PP were found to be independent predictors of elevated C-F PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased Ke rate, hypothetically through generalized vasculopathy.
Zhe
Xing-wei
XW
Division of Nephrology, Peking University Third Hospital, Beijing, China.
Tian
Xin-kui
XK
Chen
Wei
W
Guo
Li-juan
LJ
Gu
Yue
Y
Chen
Hui-min
HM
Tang
Li-jun
LJ
Wang
Tao
T
D000368:Aged; D001018:Aortic Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D001202:Ascitic Fluid / Q000378:metabolism; D003430:Cross-Sectional Studies; D015314:Dialysis Solutions / Q000493:pharmacokinetics; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010531:Peritoneal Dialysis, Continuous Ambulatory; D015995:Prevalence; D011673:Pulsatile Flow; D012307:Risk Factors
D015314:Dialysis Solutions