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Predictive Factors for Coronary Artery Disease among Peritoneal Dialysis Patients without Diabetic Nephropathy

Andreea Andronesi1, Luminita Iliuta, Magdalena Patruleasa

  • 1Center of Internal Medicine-Nephrology, Fundeni Clinical Institute, Bucharest, Romania ; UMF Carol Davila, Bucharest, Romania.

Maedica
|February 13, 2013
PubMed

Insights

Coronary heart disease risk is high in peritoneal dialysis patients. Independent predictors include age, smoking, low albumin, high iPTH, nephroangiosclerosis, and C-reactive protein, highlighting the need for targeted interventions.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Peritoneal dialysis patients face elevated risks of coronary heart disease (CHD) morbidity and mortality compared to non-renal patients.
  • Understanding independent predictors of CHD in this population is crucial for risk stratification and management.

Purpose of the Study:

  • To identify independent predictors of coronary heart disease (CHD) in peritoneal dialysis patients without diabetic nephropathy.
  • To analyze intima-media thickness (IMT) as a marker of atherosclerosis and its correlation with cardiovascular risk factors.

Main Methods:

  • Evaluated 116 end-stage renal disease patients on peritoneal dialysis without diabetic nephropathy for CHD and risk factors.
  • Assessed traditional risk factors (hypertension, dyslipidemia, metabolic syndrome) and dialysis-related factors (inflammation, anemia).
  • Measured intima-media thickness (IMT) in a subset of patients and correlated it with cardiovascular risk factors.

Main Results:

  • High prevalence of traditional risk factors (hypertension 95.7%, dyslipidemia 93.1%) and dialysis-related factors (inflammation 82.8%, anemia 55.2%) observed.
  • Independent predictors for CHD included age, smoking, nephroangiosclerosis, low albumin, elevated C-reactive protein (CRP), and high intact parathyroid hormone (iPTH).
  • Higher IMT (>0.89 mm) was associated with increased risks of CHD, acute coronary syndrome, and cardiovascular death.

Conclusions:

  • Peritoneal dialysis patients exhibit a high prevalence of cardiovascular risk factors, including malnutrition and inflammation.
  • Key independent predictors for CHD are age >55 years, smoking, albumin <3.5 g/dL, iPTH <150 pg/mL, and nephroangiosclerosis.
  • Increasing C-reactive protein (CRP) levels correlate with a higher gradient of coronary heart disease risk.
Abstract

Keywords:
coronary heart diseaseend-stage renal diseaseintima-media thicknessperitoneal dialysis

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