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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Association Between the Vascular Ageing of the Carotid Arteries and Different Dialysis Modalities
Boban Labovic1, Violeta Rabrenovic2, Milica Petrovic2
1Clinic of Neurology, Military Medical Academy, Belgrade, SRB.
Insights
Patients on peritoneal dialysis face a significantly higher risk of carotid artery disease compared to those on hemodialysis. This highlights the importance of monitoring vascular aging in chronic kidney disease patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Medicine
Background:
- Chronic kidney disease (CKD) is a global health issue.
- CKD patients have a higher risk of cardiovascular complications.
- Vascular aging is accelerated in end-stage renal disease (ESRD).
Purpose of the Study:
- To evaluate vascular aging in ESRD patients undergoing different renal replacement therapies.
- To analyze clinical, laboratory parameters, and carotid intima-media thickness (CIMT).
- To identify predictors of carotid disease and compare prevalence between hemodialysis and peritoneal dialysis groups.
Main Methods:
- Retrospective cohort study.
- Included 59 ESRD patients (30 hemodialysis, 29 peritoneal dialysis).
- Assessed CIMT and carotid artery stenosis.
Main Results:
- Peritoneal dialysis patients showed a higher prevalence of carotid disease (72.4% vs. 46.7%, p=0.044).
- Pathological carotid findings correlated with peritoneal dialysis treatment (r=-0.262, p=0.045).
- Peritoneal dialysis was an independent predictor of carotid disease (OR=3.24, 95% CI=1.00-13.47).
Conclusions:
- Peritoneal dialysis patients have a 3.24 times higher likelihood of developing carotid disease.
- Monitoring vascular aging and carotid changes is crucial for CKD patients.
- Dialysis modality selection may impact carotid atherosclerotic disease progression.
Abstract:
Background Chronic kidney disease is a major global health problem, significantly increasing the risk of cardiovascular complications compared to the general population. This study aimed to evaluate vascular aging in patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis by analyzing clinical and laboratory parameters and carotid intima-media thickness (CIMT), with the goal of identifying predictors of carotid disease and comparing the prevalence between groups. Methods We conducted a retrospective cohort study that included 59 subjects with end-stage renal disease who were treated with renal replacement therapy: peritoneal dialysis (29 subjects) and hemodialysis (30 subjects). Results When observing these parameters collectively, it was noted that at least one of the parameters (intima-media thickness greater than 0.7 mm or stenosis of the carotid arteries) was statistically more frequently present in the group of patients treated with the peritoneal dialysis method compared to those treated with the hemodialysis method (72.4% vs. 46.7%; p=0.044). The correlation analysis showed that pathological findings on the carotid blood vessels statistically significantly correlated with assignment to the group treated with peritoneal dialysis (r=-0.262, p=0.045). According to the results of multivariate logistic regression analysis, the independent factor associated with carotid disease belonged to the peritoneal dialysis group (odds ratio=3.24; 95% confidence interval=1.00-13.47). Subjects treated with peritoneal dialysis had a 3.244 times greater chance of developing carotid disease. Conclusion Monitoring clinical and laboratory parameters and changes in carotid blood vessels is important in patients with chronic kidney disease to prevent carotid atherosclerotic disease and other cardiovascular diseases. In our study, patients undergoing peritoneal dialysis had a 3.244 times higher likelihood of developing carotid disease. A careful selection of dialysis modality may influence the slowing of carotid atherosclerotic disease progression.
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