title: Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study.
abstract: BACKGROUND
  The prevalence of subclinical atherosclerosis and the main predictors of progression of this condition in patients undergoing peritoneal dialysis (PD) have been insufficiently investigated.
  
  
  OBJECTIVE
  Following a prospective, multicenter, observational design, we studied 237 patients who were treated with PD for ≥3 months, without any clinical background of cardiovascular (CV) disease. Our objectives were the following: (1) to investigate the prevalence of subclinical atherosclerosis, as compared to a control group of age- and sex-matched healthy individuals, and (2) to disclose PD technique-related predictors of progression of disease during a 24-month follow-up period. We used vascular ultrasound for characterization of subclinical atherosclerotic disease.
  
  
  RESULTS
  A total of 123 patients (51.9%) vs. 79 controls (33.5%) presented ≥1 carotid plaque, and 114 patients (48.3%) vs. 72 controls (30.5%) ≥1 femoral plaque, at baseline evaluation (p < 0.0005). Progression of disease, either in clinical or ultrasound (new plaques) terms, affected 62.6% of patients. Multivariate analysis identified age, carotid intima-media thickness, presence of ≥1 carotid plaque, and serum levels of 25OH vitamin D and C-reactive protein (CRP) at baseline as independent correlates of progression of atherosclerotic disease. On the contrary, PD technique-related variables did not show any association with this outcome.
  
  
  CONCLUSIONS
  Atherosclerotic vascular disease is frequent among asymptomatic patients undergoing PD. Older age, pre-existent disease (assessed by vascular ultrasound), and serum levels of 25OH vitamin D and CRP are independent markers of the progression of this condition. These findings may contribute to improve identification of subpopulations with a high risk of CV events, deserving intensified measures of prevention.
authors.affiliation: Division of Nephrology, University Hospital A Coruña, A Coruña, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Pérez Fontán
authors.forename: Mercè
authors.initials: M
authors.lastname: Borràs Sans
authors.forename: Maria Auxiliadora
authors.initials: MA
authors.lastname: Bajo Rubio
authors.forename: Ana
authors.initials: A
authors.lastname: Rodriguez-Carmona
authors.forename: Angels
authors.initials: A
authors.lastname: Betriu
authors.forename: José Maria
authors.initials: JM
authors.lastname: Valdivielso
authors.forename: Elvira
authors.initials: E
authors.lastname: Fernández
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D058625:End Stage Liver Disease / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000150:complications*; D011446:Prospective Studies; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D014807:Vitamin D
keywords: Carotid atherosclerosis; Peritoneal dialysis; Vitamin D