title: Prognostic value of arterial pulse wave velocity in peritoneal dialysis patients.
abstract: BACKGROUND
  Cardiovascular disease 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 of PD patients. We examined the prognostic value and factors that govern the longitudinal change of arterial pulse wave velocity (PWV) in Chinese PD patients.
  
  
  METHODS
  We enrolled 155 new PD patients. PWV was measured at baseline and then repeated after 2 years of follow-up.
  
  
  RESULTS
  At 24 months, the survival of patients with baseline carotid-femoral (CF)-PWV above 10 m/s was significantly worse than that of those with CF-PWV below 10 m/s (76.1 vs. 88.6%, p = 0.006). However, after adjusting for confounding factors, CF-PWV was not an independent predictor of survival. Amongst the 100 patients who had repeated PWV measurement after 2 years, the average CF-PWV increased from 9.92 ± 2.04 to 11.00 ± 2.30 m/s (p < 0.0001). The change in CF-PWV over 2 years significantly correlated with systolic blood pressure (r = 0.241, p = 0.036), serum calcium level (r = 0.231, p = 0.044), and normalized protein nitrogen appearance (NPNA) (r = -0.337, p = 0.001).
  
  
  CONCLUSIONS
  A high baseline CF-PWV was associated with a lower overall survival of Chinese PD patients, but the prognostic value of CF-PWV disappeared after adjusting for confounding factors. After 2 years of PD, most patients had progressive increase in CF-PWV; the magnitude of increase is related to systolic blood pressure, serum calcium level, and baseline NPNA. Further study is needed to determine whether serial measurement of CF-PWV provides additional prognostic information.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, SAR, China. ccszeto@cuhk.edu.hk
authors.forename: Cheuk-Chun
authors.initials: CC
authors.lastname: Szeto
authors.forename: Bonnie Ching-Ha
authors.initials: BC
authors.lastname: Kwan
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Chi-Bon
authors.initials: CB
authors.lastname: Leung
authors.forename: Man-Ching
authors.initials: MC
authors.lastname: Law
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002118:Calcium / Q000097:blood; D002339:Carotid Arteries / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011673:Pulsatile Flow; D018709:Statistics, Nonparametric; D014652:Vascular Diseases / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D059289:Vascular Stiffness
chemical_list: D002118:Calcium