Arterial pulse wave velocity and peritoneal transport characteristics independently predict hospitalization in Chinese peritoneal dialysis patients.
OBJECTIVE
Cardiovascular disease (CVD) is the most common cause of mortality in chronic peritoneal dialysis (PD) patients. Increased arterial stiffness may be related to a high peritoneal permeability resulting in fluid overload in PD patients. We studied the relations between arterial stiffness, peritoneal transport, and radiographic parameters of systemic fluid overload in a cohort of Chinese PD patients.


METHODS
Prospective cohort study.


METHODS
University referral center.


METHODS
We studied 107 PD patients. Vascular pedicle width and cardiothoracic ratio were measured from a plain postero-anterior chest radiograph. Pulse wave velocity (PWV) was determined at carotid-femoral (C-F) and carotid-radial sites. Peritoneal transport was determined by the dialysate-to-plasma ratio (D/P) of creatinine at 4 hours of dwell. Patients were followed for 9.4 +/- 4.6 months.


METHODS
Duration of hospitalization; actuarial and technique survival.


RESULTS
There were no relationships between radiographic measures, arterial PWV, and D/P creatinine. However, both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. None of the parameters correlated with mortality in this study.


CONCLUSIONS
There were no relationships between radiological parameters of fluid overload, peritoneal transport characteristics, and arterial PWV. Both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. Our result suggests that arterial stiffness and high peritoneal transport each contribute to the development of CVD in this group of patients.
Gao
Ni
N
Department of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Kwan
Bonnie Ching-Ha
BC
Chow
Kai-Ming
KM
Chung
Kwok-Yi
KY
Pang
Wing-Fai
WF
Leung
Chi-Bon
CB
Li
Philip Kam-Tao
PK
Szeto
Cheuk-Chun
CC
D001158:Arteries; D001783:Blood Flow Velocity; D002681:China; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011674:Pulse