title: The association between arterial stiffness and fluid status in peritoneal dialysis patients.
abstract: OBJECTIVE
  In this study our aim was to evaluate the relationship between degree of fluid status and arterial stiffness measured by pulse wave velocity (PWV) in peritoneal dialysis (PD) patients. Fluid status was determined by different methods including fluid overload measured by bioimpedance (Body Composition Monitor, BCM), calf normalized resistivity (CNR), plasma N-terminal fragment of B-type natriuretic peptide (NT-proBNP) and extracellular to intracellular water ratio (ECW/ICW).
  
  
  METHODS
  Sixty PD patients were evaluated. They were stratified into normo- and hypervolemic groups according to their fluid overload (FO). CNR was calculated from resistance at 5 kHz using calf bioimpedance spectroscopy. Arterial stiffness was assessed by PWV. Additionally, all patients underwent transthoracic echocardiography and had levels of NT-proBNP measured.
  
  
  RESULTS
  PWV was higher in the hypervolemic compared to normovolemic patients (9.99 ± 2.4 m/sec vs 7.48 ± 2.3 m/sec, p < 0.001). Hypervolemic patients had higher NT-proBNP levels (3065 ± 981 pg/mL vs 1095 ± 502 pg/mL, p < 0.001), a higher ratio of ECW/ICW; (0.93 ± 0.11 vs 0.81 ± 0.08, p < 0.001) and lower CNR (13.7 ± 2.4 vs 16.0 ± 3.3 W m(3)/kg(*)10(-2), p = 0.005). NT-pro BNP level, ECW/ICW ratio, relative FO, and left ventricular (LV) mass index were positively and CNR negatively correlated with PWV. Relative FO and CNR independently predicted PWV in multivariate analysis adjusted for age, duration of PD, body mass index and mean arterial pressure.
  
  
  CONCLUSIONS
  Arterial stiffness is increased in fluid-overloaded PD patients. Our results indicated that fluid status is an independent predictor of PWV.
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Ismail
authors.initials: I
authors.lastname: Kocyigit
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Murat Hayri
authors.initials: MH
authors.lastname: Sipahioglu
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Orscelik
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Aydin
authors.initials: A
authors.lastname: Unal
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Samer R
authors.initials: SR
authors.lastname: Abbas
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Fansan
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Bulent
authors.initials: B
authors.lastname: Tokgoz
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Dogan
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Oktay
authors.initials: O
authors.lastname: Oymak
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
authors.affiliation: Erciyes University Medical Faculty, Department of Nephrology, Kayseri, Turkey; Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey; and Renal Research Institute, New York City, NY, USA.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
mesh_terms: D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000502:physiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D010446:Peptide Fragments / Q000032:analysis*; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D063177:Pulse Wave Analysis; D013057:Spectrum Analysis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000502:physiology*; D014883:Water-Electrolyte Imbalance / Q000209:etiology* / Q000503:physiopathology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Arterial stiffness; fluid status; peritoneal dialysis