Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients--an observational study.
BACKGROUND
Patients on peritoneal and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. The atherosclerosis is associated with increased arterial stiffness, endothelial dysfunction and elevated oxidative stress and inflammation. The aims of this study are to investigate the effects of peritoneal and hemodialysis on arterial stiffness, vascular function, myocardial structure and function, oxidative stress and inflammation in incident patients with end stage kidney disease.


METHODS
This is an observational study. Eighty stage five CKD patients will be enrolled and followed for one-year. Primary outcome measures will be changes in 1) arterial stiffness measured by aortic pulse wave velocity, 2) oxidative stress assessed by plasma F2 isoprostanes and 3) inflammation measured by plasma pentraxin-3. Secondary outcomes will include additional measures of oxidative stress and inflammation, changes in vascular function assessed using the brachial artery reactivity technique, carotid artery intimal medial thickness, augmentation index and trans thoracic echocardiography to assess left ventricular geometry, and systolic and diastolic function. Patients will undergo these measures at baseline (6-8 weeks prior to starting dialysis therapy), then at six and 12 months after starting dialysis.


CONCLUSIONS
The results of this study may guide the choice of dialysis modality in the first year of treatment. It may also lead to a larger study prospectively assessing the effect of dialysis modality on cardiovascular morbidity and mortality.


BACKGROUND
ACTRN12609000049279.
Fassett
Robert G
RG
Renal Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. rfassett@mac.com
Driver
Ritza
R
Healy
Helen
H
Ranganathan
Dwarakanathan
D
Ratanjee
Sharad
S
Robertson
Iain K
IK
Geraghty
Dominic P
DP
Sharman
James E
JE
Coombes
Jeff S
JS
D050197:Atherosclerosis / Q000097:blood / Q000209:etiology*; D001916:Brachial Artery / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002339:Carotid Arteries / Q000648:ultrastructure; D002986:Clinical Trials as Topic / Q000379:methods*; D004452:Echocardiography; D028441:F2-Isoprostanes / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008365:Manometry; D015337:Multicenter Studies as Topic / Q000379:methods*; D005996:Nitroglycerin; D018384:Oxidative Stress; D018579:Patient Selection; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012107:Research Design; D000683:Serum Amyloid P-Component / Q000032:analysis; D017539:Tunica Intima / Q000648:ultrastructure; D017540:Tunica Media / Q000648:ultrastructure; D016277:Ventricular Function, Left; D000099153:Pentraxins
D002097:C-Reactive Protein; D028441:F2-Isoprostanes; D005996:Nitroglycerin; D000683:Serum Amyloid P-Component; D000099153:Pentraxins