The impact of dialysis modality on arterial stiffness in patients with end-stage renal disease.
BACKGROUND
Arterial stiffness determined by brachial-ankle pulse wave velocity (baPWV) has been established as a powerful predictor of cardiovascular mortality in hemodialysis (HD) patients. There are, however, few studies regarding the comparative impact of different renal replacement therapies (RRTs) on PWV. Therefore, we conducted a cross-sectional study to compare arterial wall properties and cardiac function between patients treated with continuous ambulatory peritoneal dialysis (CAPD) and those with HD who were matched for age, dialysis duration, and blood pressure.


METHODS
baPWV and transthoracic echocardiography (TTE) were performed in HD patients (n = 23) after 1 h of midweek dialysis session and CAPD patients (n = 26) with empty abdomen after drainage of dialysate. The baseline data were retrospectively reviewed.


RESULTS
baPWV was significantly higher in HD patients than in CAPD patients (18.1 +/- 2.8 vs. 16.1 +/- 2.7 m/s, p = 0.015). TTE revealed significantly increased E/E', left atrial volume index (LAVI), and inferior vena cava (IVC) diameter index in HD patients compared with CAPD patients (p < 0.05). In a multivariate regression analysis adjusted for dialysis modality, age, systolic BP, residual glomerular filtration rate, diabetes, and echocardiographic parameters, HD was independently associated with increased baPWV.


CONCLUSIONS
This study showed that HD patients had significantly increased arterial stiffness and severe diastolic dysfunction compared with CAPD patients.
Chang
Jae Hyun
JH
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Yoon
Se-Jung
SJ
Han
Seung Hyeok
SH
Shin
Sug Kyun
SK
Jeon
Dong Woon
DW
Yang
Joo Young
JY
Kang
Ea Wha
EW
D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011673:Pulsatile Flow / Q000502:physiology*; D012189:Retrospective Studies; D014661:Vasoconstriction / Q000502:physiology*; D014664:Vasodilation / Q000502:physiology*