title: Predictive Factors for Coronary Artery Disease among Peritoneal Dialysis Patients without Diabetic Nephropathy.
abstract: OBJECTIVE
  Scientific literature indicates that the risk of coronary heart disease morbidity and death among peritoneal dialysis patients exceeds risk observed in non-renal patients. The aims of this study were to establish the independent predictors associated with increased risk of coronary heart disease in peritoneal dialysis patients without diabetic nephropathy.
  
  
  METHODS
  A number of 116 end-stage renal disease patients without diabetic nephropathy undergoing peritoneal dialysis were evaluated for coronary heart disease and predictive risk factors were investigated and identified. Also intima-media thickness measurements, as an early sign of atherosclerosis, were analyzed in a subset of patients in correlation with a number of traditional and non-traditional cardiovascular risk factors.
  
  
  RESULTS
  The study sample was found to be characterized by a high prevalence of traditional risk factors: hypertension (95.7%), dyslipidemia (93.1%) and metabolic syndrome (58.6%), but also of dialysis-related risk factors: inflammation (82.8%) and anemia (55.2%). Independent variables found to be associated in regression analysis with coronary heart disease were: age, smoking status, nephroangiosclerosis, albumin, C-reactive protein and iPTH levels. Intima-media thickness was significantly higher in patients with coronary heart disease, values greater than 0.89 mm being associated with increased risks for coronary heart disease, acute coronary syndrome and cardiovascular death.
  
  
  CONCLUSIONS
  The prevalence of traditional cardiovascular risk factors in these peritoneal dialysis patients is extremely high, but there are also some other factors involved, especially malnutrition and inflammation. Age higher than 55 years, smoking, albumin less than 3.5 g/dl, iPTH less than 150 pg/ml and nephroangiosclerosis were associated with highest odds ratio for coronary heart disease. An increasing CRP levels was associated with an increasing gradient for coronary heart disease risk.
authors: Center of Internal Medicine-Nephrology, Fundeni Clinical Institute, Bucharest, Romania  ; UMF Carol Davila, Bucharest, Romania.
authors: Andreea
authors: A
authors: Andronesi
authors: Luminita
authors: L
authors: Iliuta
authors: Magdalena
authors: M
authors: Patruleasa
authors: Camelia
authors: C
authors: Achim
authors: Gener
authors: G
authors: Ismail
authors: Raluca
authors: R
authors: Bobeica
authors: Elena
authors: E
authors: Rusu
authors: Diana
authors: D
authors: Zilisteanu
authors: Danut
authors: D
authors: Andronesi
authors: Otilia
authors: O
authors: Motoi
authors: Alecse
authors: A
authors: Ditoiu
authors: Ionel
authors: I
authors: Copaci
authors: Mihai
authors: M
authors: Voiculescu
keywords: coronary heart disease; end-stage renal disease; intima-media thickness; peritoneal dialysis
references: Am J Kidney Dis. 1998 Nov;32(5):853-906
references: 9820460
references: Perit Dial Int. 2009 Jan-Feb;29(1):64-71
references: 19164255
references: Am J Kidney Dis. 2002 Feb;39(2):227-44
references: 11840363
references: Am J Kidney Dis. 2011 Jun;57(6):894-902
references: 21489668
references: Arch Med Sci. 2011 Dec 31;7(6):984-92
references: 22328881
references: Nutr Metab Cardiovasc Dis. 2012 Jul;22(7):591-7
references: 21196102
references: N Engl J Med. 1974 Mar 28;290(13):697-701
references: 4813742
references: Nephron. 1982;31(2):103-10
references: 7121651
references: Perit Dial Int. 2009 Feb;29 Suppl 2:S149-52
references: 19270205
references: J Am Soc Nephrol. 2002 Jul;13(7):1918-27
references: 12089389
references: Atherosclerosis. 2011 Jun;216(2):446-51
references: 21414625
references: Am J Kidney Dis. 1998 Nov;32(5 Suppl 3):S112-9
references: 9820470
references: J Am Coll Cardiol. 2009 Jun 9;53(23):2129-40
references: 19497438
references: Perit Dial Int. 2009 Feb;29 Suppl 2:S137-44
references: 19270203
references: Am J Kidney Dis. 2011 Aug;58(2):257-65
references: 21664017
references: Am J Kidney Dis. 2003 Apr;41(4 Suppl 3):I-IV, S1-91
references: 12671933
references: Curr Cardiol Rep. 2009 Jan;11(1):21-7
references: 19091171
references: J Am Coll Cardiol. 2009 Apr 14;53(15):1265-72
references: 19358939