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- Tian, SL, et al.
(författare)
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Presence of peripheral arterial disease predicts loss of residual renal function in incident CAPD patients
- 2012
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Ingår i: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. - : SAGE Publications. - 1718-4304 .- 0896-8608. ; 32:1, s. 67-72
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Tidskriftsartikel (refereegranskat)abstract
- Accelerated cardiovascular disease (CVD), including peripheral arterial disease (PAD), is very common in patients with end-stage renal disease. Residual renal function (RRF) is a strong predictor of patient survival that is suggested to be linked to the degree of CVD. However, the relationship between PAD and decline in RRF has not previously been measured. Methods We studied incident continuous ambulatory peritoneal dialysis patients from Peking University Third Hospital. An ankle brachial index of less than 0.9 was used to diagnose PAD. Residual renal function (RRF) was determined as the mean of 24-hour urea and creatinine clearances (glomerular filtration rate). The Cox proportional hazards model was used to identify factors predicting loss of RRF. Results The study included 86 patients (age: 61 ± 14 years; men: 51%), 23 of whom had PAD at baseline. Mean follow-up was 19 months (median: 18 months; range: 6 – 30 months). In univariate analysis, baseline PAD, peritonitis during follow-up, inflammation (C-reactive protein), serum uric acid, CaxP, and serum phosphate were all significantly associated with a greater-than-50% decrease in RRF during follow-up. In multivariate analysis, only baseline PAD, CaxP, and peritonitis were independently associated with a decline in RRF. Conclusions Our study suggests that PAD may be a clinically important marker of CVD predicting the loss of RRF. It remains to be determined whether interventions aimed at decreasing PAD may also improve renal vascular status and thus slow the rate of RRF decline.
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- Zhe, XW, et al.
(författare)
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Hypertriglyceridemic waist is associated with increased carotid atherosclerosis in chronic kidney disease patients
- 2012
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Ingår i: Nephron. Clinical practice. - : S. Karger AG. - 1660-2110. ; 122:3-4, s. 146-152
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Patients with chronic kidney disease (CKD) have an unacceptably high risk of death, primarily as a result of cardiovascular disease (CVD). The ‘hypertriglyceridemic waist' phenotype has been proposed as a simple and strong predictor of CVD risk. Therefore, we investigated the relationship between the hypertriglyceridemic waist phenotype and carotid atherosclerosis in CKD patients. <b><i>Methods:</i></b> In a cross-sectional study, we enrolled 785 prevalent CKD patients [416 males, aged 44.6 years (21.7-69.4), glomerular filtration rate 52.5 ml/min/1.73 m<sup>2</sup> (5.3-119.4)]. We divided the patients into three groups: group 1: waist circumference >90 cm in men or >85 cm in women and triglycerides ≥2 mmol/l (n = 109); group 3: waist circumference ≤90 cm in men or ≤85 cm in women and triglycerides <2 mmol/l (n = 379), and group 2: the remaining patients (n = 297). Routine biochemical parameters and carotid artery intima-media thickness (IMT) were measured. <b><i>Results:</i></b> The prevalence of the hypertriglyceridemic waist phenotypes was 13.8% in the CKD patients. Triglyceride, total cholesterol, HDL-cholesterol and LDL-cholesterol concentrations in group 1 were significantly higher than those in group 3. Carotid artery IMT of the hypertriglyceridemic waist group was the highest. <b><i>Conclusion:</i></b> The hypertriglyceridemic waist phenotype was associated with worse carotid atherosclerosis in CKD patients. This suggests that the hypertriglyceridemic waist phenotype may be useful for predicting CVD risk in CKD patients.
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- Zhe, XW, et al.
(författare)
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Pulse wave velocity is associated with metabolic syndrome components in CAPD patients
- 2008
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Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 28:4, s. 641-646
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Overall, the proportion of deaths due to cardiovascular disease (CVD) reached 40–50% in dialysis patients. Pulse wave velocity (PWV) reflects arterial stiffness and may provide an integrated index of vascular status and CVD risk. Individual components of the metabolic syndrome (MetS) are well-established cardiovascular risk factors. Thus we conducted a cross-sectional study in continuous ambulatory peritoneal dialysis (CAPD) patients to explore the association of MetS components with PWV. <i>Methods:</i> Prevalent CAPD patients (n = 148, 63 M/85 F) were categorized according to the number of traits of the MetS into one of three groups (No MetS, Risk of MetS, MetS). Due to the effect of peritoneal dialysis (PD), waist circumference was not assessed. Aortic stiffness was assessed by carotid-femoral PWV (C-F PWV). <i>Results:</i> Patients’ MetS trait numbers were positively associated with C-F PWV (r = 0.301, p < 0.01), pulse pressure (r = 0.256, p < 0.01), systolic blood pressure (r = 0.233, p < 0.01), and serum albumin (r = 0.205, p < 0.05). In a multivariate regression analysis, PWV was independently determined by age (p < 0.01) and MetS score (p = 0.01). Adjusted R<sup>2</sup> of the model was 0.24. <i>Conclusion:</i> MetS traits were closely associated with an increased C-F PWV, even after adjustment for confounders. This suggests that commonly recognized MetS criteria are useful also when predicting CVD in CAPD patients.
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