Risk factors of ischemic cardiac disease in patients on continuous ambulatory peritoneal dialysis

Area of Science:

• Cardiovascular Science
• Nephrology
• Hematology

Background:

• Elevated fibrinogen, factor VII coagulant activity (F VIIc), and plasminogen activator inhibitor (PAI-1) are linked to thrombotic events and atherothrombotic cardiovascular disease.
• These coagulation factors are crucial in the development of blood clots and cardiovascular disease progression.

Purpose of the Study:

• To evaluate plasma levels of fibrinogen, F VIIc, PAI-1, tissue plasminogen activator (t-PA), basal insulin, and lipid profiles in continuous ambulatory peritoneal dialysis (CAPD) patients.
• To compare these parameters in CAPD patients with hemodialysis (HD) patients and healthy subjects.

Main Methods:

• Plasma levels of fibrinogen, F VIIc, PAI-1, t-PA, insulin, and lipids were measured.
• Patients included 15 CAPD patients, 33 HD patients, and 59 healthy controls.

Main Results:

• CAPD patients exhibited significantly increased total cholesterol and triglycerides compared to controls, with no difference in HDL cholesterol.
• Fibrinogen and F VIIc were significantly higher in both CAPD and HD groups versus controls.
• PAI-1 and t-PA levels were elevated in CAPD patients, potentially due to endothelial cell activation from dialysis solutions.

Conclusions:

• CAPD patients display a hypercoagulable and hypofibrinolytic state, indicated by elevated fibrinogen, F VIIc, PAI-1, and t-PA.
• This prothrombotic condition in CAPD patients may increase their risk of atherothrombotic cardiovascular events.