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Articles |
St. Barnabas Hospital Medical Center, Bronx, New York.
Cardiovascular disease is the leading cause of death in patients undergoing maintenance dialysis. This study was undertaken to evaluate the lipid abnormalities and body composition by bioelectrical impedance in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The patients were between the ages of 28 and 77 and had been on dialysis for periods ranging from 6-48 months. Body composition studies performed by electrical impedance showed that the CAPD patients generally had elevated levels of body fat. Most of these patients had waist-to-hip fat ratios of more than 1.0, and lean tissue was decreased. Serum chemistries showed that most of the patients had albumin levels less than 3.5 g/dL. The most frequent lipid abnormalities found were: hypertriglyceridemia; hypercholesterolemia; decreased HDL levels; elevated cholesterol/HDL and apoproteins (Apo B/A-1); and elevated lipoprotein [Lp(a)] levels. Cardiovascular disease was prevalent in the patients studied. Ten had a positive history of angina, with three documented myocardial infarction and two documented cardiovascular disease. In conclusion, standard CAPD treatment may increase the risk of cardiovascular disease.
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