Advanced glycation end products, aortic stiffness, and wave reflection in peritoneal dialysis as compared to hemodialysis.
BACKGROUND
Modification of vascular extracellular matrix by advanced glycation end products (AGEs) may result in vascular stiffness. Because of higher exposure to glucose, we hypothesized that patients on peritoneal dialysis (PD) may have higher tissue levels of AGEs, increased vascular stiffness, and enhanced central augmentation pressure as compared to hemodialysis patients (HD).


METHODS
In a cross-sectional study, 43 PD were matched to 43 HD based on age, gender, diabetes, and dialysis vintage. Tissue levels of AGEs were assessed by skin autofluorescence (skin AF). Aortic stiffness was measured by carotid-femoral pulse wave velocity (cf-PWV), and heart rate-adjusted augmentation pressure (AP@75) was performed by arterial tonometry.


RESULTS
Baseline characteristics were similar in both groups except for lower prevalence of cardiovascular disease (CVD) and higher exposure to smoking in PD. Skin AF and cf-PWV were not statistically different, but PD patients had a lower AP@75 (P = 0.023). However, after adjustments for prevalence of CVD and smoking status, skin AF was higher in PD by 0.587 AU (95 % CI 0.091-1.215, P = 0.020), and cf-PWV was higher in PD by 2.20 m/s (95 % CI 0.56-3.84, P = 0.009), while AP@75 was not different. Overall, there was a significant association between skin AF and cf-PWV and AP@75.


CONCLUSIONS
Skin AF and aortic stiffness were higher in PD after adjustments for imbalances in baseline characteristics. Independent of dialysis modality, there was a positive association between skin AF, aortic stiffness, and enhanced wave reflection.
Service de Néphrologie, CHU de Québec-L'Hôtel-Dieu de Québec, 11, Côte du Palais, Quebec, QC, G1R 2J6, Canada.
Fabrice
F
Mac-Way
Véronique
V
Couture
Mihai S
MS
Utescu
Sophie
S
Ignace
Sacha A
SA
De Serres
Renée-Claude
RC
Loignon
Karine
K
Marquis
Richard
R
Larivière
Mohsen
M
Agharazii
D000368:Aged; D001011:Aorta; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging; D010530:Peritoneal Dialysis; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D012867:Skin / Q000378:metabolism; D059289:Vascular Stiffness
D017127:Glycation End Products, Advanced