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Perit Dial Int 30(1): 80-85
2010
© 2010 International Society for Peritoneal Dialysis
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Clinical

ARTERIAL PULSE WAVE VELOCITY AND PERITONEAL TRANSPORT CHARACTERISTICS INDEPENDENTLY PREDICT HOSPITALIZATION IN CHINESE PERITONEAL DIALYSIS PATIENTS

Ni Gao, Bonnie Ching-Ha Kwan, Kai-Ming Chow, Kwok-Yi Chung, Wing-Fai Pang, Chi-Bon Leung, Philip Kam-Tao Li and Cheuk-Chun Szeto

Department of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

Correspondence to: C.C. Szeto, Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China. ccszeto{at}cuhk.edu.hk

{diamondsuit} Objective: Cardiovascular disease (CVD) is the most common cause of mortality in chronic peritoneal dialysis (PD) patients. Increased arterial stiffness may be related to a high peritoneal permeability resulting in fluid overload in PD patients. We studied the relations between arterial stiffness, peritoneal transport, and radiographic parameters of systemic fluid overload in a cohort of Chinese PD patients.

{diamondsuit} Design: Prospective cohort study.

{diamondsuit} Setting: University referral center.

{diamondsuit} Patients: We studied 107 PD patients. Vascular pedicle width and cardiothoracic ratio were measured from a plain postero-anterior chest radiograph. Pulse wave velocity (PWV) was determined at carotid–femoral (C-F) and carotid–radial sites. Peritoneal transport was determined by the dialysate-to-plasma ratio (D/P) of creatinine at 4 hours of dwell. Patients were followed for 9.4 ± 4.6 months.

{diamondsuit} Outcome Measures: Duration of hospitalization; actuarial and technique survival.

{diamondsuit} Results: There were no relationships between radiographic measures, arterial PWV, and D/P creatinine. However, both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. None of the parameters correlated with mortality in this study.

{diamondsuit} Conclusions: There were no relationships between radiological parameters of fluid overload, peritoneal transport characteristics, and arterial PWV. Both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. Our result suggests that arterial stiffness and high peritoneal transport each contribute to the development of CVD in this group of patients.

KEY WORDS: Vascular pedicle width; cardiothoracic ratio; pulse wave velocity; peritoneal transport characteristics; cardiovascular disease.

Received 9 December 2008; accepted 25 March 2009.






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