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Published on: September 27, 2024
Baseline carotid intima-media thickness is associated with cardiovascular morbidity and mortality in peritoneal
Ebru Asicioglu1, Arzu Velioglu1, Hakki Arikan1
1Department of Nephrology, Marmara University Pendik Teaching Hospital, Istanbul, Turkey.
Insights
Carotid intima-media thickness (CIMT) is a key indicator of atherosclerosis in peritoneal dialysis (PD) patients. Higher CIMT at baseline is linked to increased cardiovascular disease (CVD) and mortality risk in PD patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Carotid intima-media thickness (CIMT) is an established early marker of atherosclerosis.
- Peritoneal dialysis (PD) patients exhibit increased CIMT, but its association with cardiovascular disease (CVD) and mortality remains unclear.
- Fibroblast growth factor-23 (FGF-23) is implicated in vascular calcification and mortality in hemodialysis patients.
Purpose of the Study:
- To investigate the association of baseline CIMT and FGF-23 levels with the incidence of CVD and all-cause mortality in patients undergoing PD.
Main Methods:
- A cohort of 55 PD patients was studied.
- CVD was defined as ischemic heart disease, stroke, or peripheral artery disease.
- Plasma intact FGF-23 levels and CIMT via ultrasonography were measured at baseline.
Main Results:
- Over a median follow-up of 47.1 months, 21 patients developed CVD and 12 died.
- Patients with CVD were older, had lower albumin, and significantly higher CIMT compared to those without CVD.
- Higher baseline CIMT (>0.75 mm) was associated with cardiovascular mortality, while FGF-23 showed no significant correlations.
Conclusions:
- Baseline CIMT is a significant predictor of both CVD and mortality in PD patients.
- CIMT measurement may aid in risk stratification for cardiovascular events and death in this population.
- FGF-23 did not emerge as a significant predictor in this PD cohort.
Abstract:
Carotid intima-media thickness (CIMT) is an early marker of atherosclerosis and is increased in peritoneal dialysis (PD) patients. Association of CIMT with cardiovascular disease (CVD) or mortality is less clear. Fibroblast growth factor-23 (FGF-23) is a hormone associated with vascular calcification, atherosclerosis, and mortality in the hemodialysis population. We investigated whether baseline CIMT and FGF-23 are associated with CVD and mortality in PD patients. Fifty-five PD patients were included. CVD was defined as ischemic heart disease, stroke, or peripheral artery disease. Intact FGF-23 was measured in plasma. CIMT was measured by ultrasonography. Twenty-one patients developed CVD and 12 died over 47.1 ± 33.8 months. Patients with CVD were older (55.9 ± 10.5 vs. 42.5 ± 12.9 years, P < .01), had lower albumin (3.8 ± 0.5 vs. 4.2 ± 0.3 g/dL, P < .01) and higher CIMT (0.87 ± 0.22 vs. 0.61 ± 0.11 mm, P < .01). Patients with mortality were also older (53.5 ± 11.5 vs. 45.8 ± 13.8 years, P = .05), had lower albumin (3.7 ± 0.6 vs. 4.1 ± 0.3 g/dL, P < .01), higher CRP (15.0 ± 8.5 vs. 7.6 ± 8.4 mg/L, P < .01) and CIMT (0.9 ± 0.3 vs. 0.6 ± 0.1 mm, P < .01). Albumin and CIMT were associated with CVD and CIMT > 0.75 mm was associated with cardiovascular mortality. FGF-23 did not show any correlations. CIMT at baseline is associated with CVD and mortality in PD patients.
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