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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Peritoneal Membrane Arteriolar Structure in Conjunction with Traditional Cardiovascular System

Rafal Donderski1, Paweł Stróżecki2, Beata Sulikowska2

  • 1Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum, Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland, rafdon@o2.pl.

Kidney & Blood Pressure Research
|June 26, 2018
PubMed

Insights

Peritoneal membrane arteriolar changes in chronic kidney disease (CKD) patients are linked to cardiovascular damage. This study assessed these changes in diabetic and non-diabetic CKD stage 5 patients before dialysis.

Area of Science:

  • Nephrology
  • Cardiology
  • Pathology

Background:

  • Cardiovascular complications increase mortality in chronic kidney disease (CKD) patients.
  • Peritoneal membrane structural changes occur in CKD patients, impacting treatment outcomes.
  • Assessing peritoneal membrane arterioles is crucial for understanding cardiovascular risks in CKD.

Purpose of the Study:

  • To evaluate the structure of peritoneal membrane small arteries (precapillary arterioles) in diabetic and non-diabetic CKD stage 5 patients before initiating peritoneal dialysis (PD).
  • To investigate the relationship between peritoneal arteriolar structure and cardiovascular abnormalities (heart, large arteries).
  • To explore correlations with selected biochemical parameters.

Main Methods:

  • Histopathological evaluation of peritoneal precapillary arterioles (wall thickness, lumen/vessel ratio) in 42 CKD stage 5 patients.
  • Assessment of cardiovascular parameters: echocardiography, intima media thickness (IMT), pulse wave velocity (PWV), ambulatory blood pressure monitoring (ABPM).
  • Analysis of biochemical markers including serum albumin, cholesterol, hemoglobin, parathormone, calcium, phosphorus, transferrin saturation, and C-reactive protein.

Main Results:

  • No significant differences in peritoneal membrane arteriolar indices (wall thickness, L/V ratio) between diabetic and non-diabetic groups.
  • Diabetic patients showed significantly higher pulse wave velocity (PWV).
  • Correlations observed between PWV and IMT/pulse pressure in non-diabetics, and PWV and age, WT and diastolic pressure in diabetics.

Conclusions:

  • Peritoneal membrane arteriolar damage appears to be an integral component of overall cardiovascular system damage in CKD stage 5 patients.
  • These findings highlight the systemic nature of vascular complications in advanced CKD.
Abstract

Keywords:
Arteriolar structureChronic kidney diseaseDiabetic and non-diabetic populationPeritoneal membraneardiovascular complications

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