Cardiovascular Risk in the Peritoneal Dialysis Patient

Overview

Journal Nat Rev Nephrol

Specialty Nephrology

Date 2010 Jun 23

PMID 20567248

Citations 79

Authors

Raymond T Krediet

Olga Balafa

Affiliations

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Abstract

Cardiovascular death is the most frequent cause of death in patients on peritoneal dialysis. Risk factors for cardiovascular death in these patients include those that affect the general population as well as those related to end-stage renal disease (ESRD) and those that are specific to peritoneal dialysis. The development of overhydration after loss of residual renal function is probably the most important cardiovascular risk factor specific to peritoneal dialysis. The high glucose load associated with peritoneal dialysis may lead to insulin resistance and to the development of an atherogenic lipid profile. The presence of glucose degradation products in conventional dialysis solutions, which leads to the local formation of advanced glycation end products, is also specific to peritoneal dialysis. Other risk factors that are not specific to peritoneal dialysis but are related to ESRD include calcifications and protein-energy wasting. When present together with inflammation and atherosclerosis, protein-energy wasting is associated with a marked increase in the risk of cardiovascular death. Obesity is not associated with increased cardiovascular risk in patients on any form of dialysis. Left ventricular hypertrophy and increased arterial stiffness are the most important risk factors for cardiovascular events in the general population.

Citing Articles

Inflammatory Burden Index: A Superior Prognostic Biomarker of Systemic Inflammation in Patients on Peritoneal Dialysis.

Chen J, Tang R, Tian N, Deng J, Ao S, Peng F J Inflamm Res. 2024; 17:10913-10927.

PMID: 39687775 PMC: 11648290. DOI: 10.2147/JIR.S393291.

Serum Malondialdehyde-Modified Low-Density Lipoprotein Level May Be a Biomarker Associated with Aortic Stiffness Among Patients Undergoing Peritoneal Dialysis.

Chang Y, Wang C, Tang C, Lin Y, Lai Y, Kuo C Life (Basel). 2024; 14(11).

PMID: 39598185 PMC: 11595923. DOI: 10.3390/life14111385.

Estimating Dietary Protein and Sodium Intake with Sodium Removal in Peritoneal Dialysis Patients.

Bontic A, Kezic A, Pavlovic J, Baralic M, Gajic S, Petrovic K Metabolites. 2024; 14(8).

PMID: 39195556 PMC: 11356164. DOI: 10.3390/metabo14080460.

Causal Association of Arterial Stiffness With the Risk of Chronic Kidney Disease.

Tian X, Chen S, Xia X, Xu Q, Zhang Y, Zhang X JACC Asia. 2024; 4(6):444-453.

PMID: 39100705 PMC: 11291385. DOI: 10.1016/j.jacasi.2023.10.010.

Serum Lipoprotein(a) Levels as a Predictor of Aortic Stiffness in Patients on Long-Term Peritoneal Dialysis.

Huang P, Hsu B, Lin Y, Tang C, Liou H, Tsai J Med Sci Monit. 2024; 30:e944348.

PMID: 38835156 PMC: 11163936. DOI: 10.12659/MSM.944348.

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