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Body composition and lipid abnormalities in hispanic and black patients on continuous ambulatory peritoneal dialysis
M A Henriquez1, A Gonzalez, J A Bemis
1St. Barnabas Hospital Medical Center, Bronx, New York.
Insights
Patients on continuous ambulatory peritoneal dialysis (CAPD) often experience abnormal body composition and lipid profiles, increasing cardiovascular disease risk. This suggests CAPD treatment may elevate risks for heart conditions in dialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Disorders
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in patients undergoing maintenance dialysis.
- Continuous ambulatory peritoneal dialysis (CAPD) is a common dialysis modality, but its impact on cardiovascular risk factors requires thorough investigation.
Purpose of the Study:
- To assess lipid abnormalities and body composition in patients on CAPD.
- To determine the prevalence of cardiovascular disease and its risk factors within this patient cohort.
Main Methods:
- Bioelectrical impedance analysis was used to evaluate body composition.
- Serum lipid profiles, including triglycerides, cholesterol, HDL, apoproteins, and lipoprotein(a), were analyzed.
- Patient history of cardiovascular events like angina and myocardial infarction was recorded.
Main Results:
- CAPD patients exhibited elevated body fat levels and decreased lean tissue, with most having a waist-to-hip ratio > 1.0.
- Common lipid abnormalities included hypertriglyceridemia, hypercholesterolemia, low HDL, and elevated cholesterol/HDL ratios, apoproteins, and lipoprotein(a).
- A significant prevalence of cardiovascular disease was observed, with multiple patients reporting angina, myocardial infarction, or documented CVD.
Conclusions:
- Standard CAPD treatment is associated with adverse body composition and dyslipidemia.
- These metabolic and body composition changes may contribute to the high prevalence of cardiovascular disease observed in CAPD patients.
- CAPD may potentially increase the risk of cardiovascular disease in patients requiring maintenance dialysis.
Abstract:
Cardiovascular disease is the leading cause of death in patients undergoing maintenance dialysis. This study was undertaken to evaluate the lipid abnormalities and body composition by bioelectrical impedance in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The patients were between the ages of 28 and 77 and had been on dialysis for periods ranging from 6-48 months. Body composition studies performed by electrical impedance showed that the CAPD patients generally had elevated levels of body fat. Most of these patients had waist-to-hip fat ratios of more than 1.0, and lean tissue was decreased. Serum chemistries showed that most of the patients had albumin levels less than 3.5 g/dL. The most frequent lipid abnormalities found were: hypertriglyceridemia; hypercholesterolemia; decreased HDL levels; elevated cholesterol/HDL and apoproteins (Apo B/A-1); and elevated lipoprotein [Lp(a)] levels. Cardiovascular disease was prevalent in the patients studied. Ten had a positive history of angina, with three documented myocardial infarction and two documented cardiovascular disease. In conclusion, standard CAPD treatment may increase the risk of cardiovascular disease.