Comparison of changes in pulse wave velocity in patients on peritoneal dialysis and hemodialysis

Area of Science:

• Nephrology
• Cardiology
• Vascular Biology

Background:

• Cardiovascular disease is the primary cause of mortality in patients undergoing dialysis.
• Aortic stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), is a recognized prognostic factor for cardiovascular events in chronic kidney disease (CKD) patients.
• Previous studies suggest potential differences in vascular health between dialysis modalities.

Purpose of the Study:

• To compare aortic stiffness between peritoneal dialysis (PD) and hemodialysis (HD) patients.
• To identify risk factors associated with increased aortic stiffness in PD patients.

Main Methods:

• Carotid-femoral pulse wave velocity (cfPWV) was measured to assess aortic stiffness.
• Univariate and multivariate analyses were performed to identify correlations between cfPWV and various clinical parameters.
• Patient data included age, phosphorus, parathyroid hormone (PTH), dyslipidemia, and dialysis modality (PD vs. HD).

Main Results:

• Peritoneal dialysis (PD) patients demonstrated significantly stiffer arteries compared to hemodialysis (HD) patients (cfPWV: 9.12 ± 2.7 m/s vs. 8.97 ± 2.52 m/s).
• Univariate analysis revealed significant correlations between cfPWV and age, phosphorus, PTH, and dyslipidemia.
• Multivariate analysis identified dyslipidemia as an independent risk factor associated with aortic stiffness (P = 0.008).

Conclusions:

• Peritoneal dialysis is associated with increased aortic stiffness in patients with end-stage renal disease.
• Dyslipidemia is a significant independent predictor of aortic stiffness in PD patients.
• These findings underscore the importance of managing cardiovascular risk factors, particularly dyslipidemia, in PD patients to mitigate mortality.