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Updated: May 28, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic
1Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Insights
Peritoneal dialysis patients exhibit increased oxidative stress and impaired endothelial function, contributing to atherosclerosis. These factors are linked to dialysis duration, urine output, and hemoglobin levels.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Nontraditional cardiovascular risk factors are crucial in patients undergoing peritoneal dialysis (PD).
- Endothelial dysfunction and oxidative stress (OS) are significant concerns in this population.
- Assessing carotid intimal medial thickness (CIMT) provides insight into structural atherosclerosis.
Purpose of the Study:
- To evaluate nontraditional cardiovascular risk factors, including endothelial function and oxidative stress, in stable PD patients.
- To assess the association between these risk factors and carotid intimal medial thickness (CIMT).
Main Methods:
- Studied 38 PD patients and 15 controls, measuring duration of dialysis (DOD), urine output (UO), and Kt/V.
- Assessed oxidative stress using serum antioxidants (Vitamin C, FRAP) and pro-oxidants (TBARS).
- Utilized high-resolution ultrasonography for CIMT, flow-mediated brachial artery dilatation (EDD), and nitrate-induced dilatation (EID).
Main Results:
- PD patients showed higher CIMT and TBARS, but lower Vitamin C, FRAP, and EDD compared to controls.
- TBARS correlated positively with DOD; Vitamin C and FRAP correlated positively with serum albumin.
- EDD correlated positively with UO, Kt/V, and hemoglobin; CIMT correlated negatively with Kt/V and hemoglobin.
Conclusions:
- PD patients experience elevated oxidative stress, diminished endothelial function, and increased atherosclerosis.
- These cardiovascular risk markers are interconnected and influenced by DOD, UO, hemoglobin, albumin, and dialysis clearance.
Abstract:
We evaluated important nontraditional cardiovascular risk factors, endothelial function and oxidative stress (OS) among stable peritoneal dialysis (PD) patients. Their association with carotid intimal medial thickness (CIMT) was also assessed. Thirty-eight adult patients (13 diabetics, 20 males) on PD for >6 months and 15 age and sex-matched controls were studied. Duration of dialysis (DOD), residual urine output (UO), weekly Kt/V urea, detailed biochemical and lipid profile were noted. OS was measured by serum concentration of antioxidants; vitamin C and ferric reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid-reactive substances (TBARS). High-resolution ultrasonography was used to determine CIMT and flow-mediated dilatation of brachial artery [endothelium-dependent dilatation (EDD)] and dilatation subsequent to nitrate spray [endothelium-independent dilatation (EID)]. Mean age, DOD, UO and Kt/V of study population were 49.3 ± 11.6 years, 19.4 ± 11.8 months, 508.2 ± 422.9 ml/day and 1.73 ± 0.24, respectively. As compared to controls PD patients had higher CIMT (0.46 ± 0.05 vs 0.50 ± 0.07 mm, P = 0.003) and TBARS (1.5 ± 0.4 vs 5.1 ± 2.3 nM/ml, P < 0.001) but lower Vitamin C (1.7 ± 0.3 vs 0.6 ± 0.2 mg%, P < 0.001), FRAP (990.8 ± 78.1 vs 328.7 ± 183.5 μM/L, P < 0.001) and EDD (26.2 ± 5.4 vs 9.8 ± 4.6 %, P < 0.001). TBARS correlated positively with DOD and negatively with hemoglobin. Vitamin C and FRAP correlated positively with serum albumin. EDD correlated positively with UO, Kt/V and hemoglobin. CIMT correlated negatively with Kt/V and hemoglobin. Among themselves CIMT correlated negatively with EDD and vitamin C. EDD correlated positively with vitamin C, while FRAP correlated positively with vitamin C and negatively with TBARS. PD patients have higher OS, poorer endothelial function and higher structural atherosclerosis. These parameters are closely linked to each other, hemoglobin, DOD, residual UO, serum albumin and small solute clearances.
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