BACKGROUND:A large body of research has investigated the effects of pro-atherogenic lipid profile on cardiovascular diseases (CVD) in peritoneal dialysis (PD) patients. However, there is a general lack of research on the association between atherogenic dyslipidemia and PD technique survival.AIM:The study aimed to define the association between dyslipidemia and PD technique survival.METHODS:It was a prospective single-centre observational study involving 40 outpatients on continuous ambulatory PD treatment for more than 3 months between 2010 and 2016 in a single centre in Ukraine. There were 27 males and 13 females. The mean age of the participants was 49.3 ± 12.2 years. The primary outcome measures were all-cause technique failure.RESULTS:Atherogenic dyslipidemia was identified in 28/40 (70 %) patients and correlated with PD adequacy parameters. During the 36-month- follow-up period technique failure occurred in 2/12 (16.6 %) patients with atherogenic dyslipidemia compared with 12 / 28 (42.9 %) patients without atherogenic dyslipidemia (χ2 = 2.5; p = 0.12). In the univariate Cox regression model, atherogenic dyslipidemia at baseline was significantly associated with a higher risk of all-cause PD technique failure (HR 4.5; 95% CI 1.6 to 12.9; χ2 = 5.5, p = 0.019).CONCLUSION:The presence of atherogenic dyslipidemia was significantly associated with a higher risk of technique failure in PD patients. This is an important issue for future research. Further well-designed clinical trials are needed to determine the impact of dyslipidemia on PD adequacy and technique survival.

Introduction:Increased oxidative stress is suggested as one of the possible mechanisms of structural and functional damage to the peritoneal membrane in peritoneal dialysis patients. But there are few available data on the association of oxidative stress with peritoneal dialysis adequacy and technique survival. The present study was undertaken to investigate the association of oxidative stress biomarkers with the peritoneal dialysis adequacy and technique survival.Methods:This prospective single-center observational study was conducted between January 2010 and May 2015. Adequacy of dialysis, malondialdehyde levels in the serum and erythrocytes (as an indicator of lipid peroxidation), the concentration of ceruloplasmin, transferrin, and sulfhydryl groups in the blood, and total peroxidase activity in erythrocyte (as indicators of antioxidant system) were determined in 44 stable ambulatory non-diabetic peritoneal dialysis patients.Results:The follow-up period was 3 years. We identified a negative correlation between the serum level of malondialdehyde in the patients and total weekly Kt/V. Peritoneal weekly CrCl was positively correlated with the levels of transferrin, total peroxidase activity, and SH– groups. Daily peritoneal ultrafiltration had a positive correlation with the total peroxidase activity and the serum transferrin levels. The results of the Kaplan–Meier analysis and the log-rank test also demonstrated a significant difference in the cumulative technique survival rate between the patients with ceruloplasmin level ≤0.19 g/l and ≥0.2 g/l.Conclusions:The results mentioned above could be considered as one of the ways to explain better technique survival in PD patients.

RESULTS: Obesity was observed in 20% of patients starting PD. We did not find differences in sex or PD modality, being older the obesity group (65.9% are 55 years versus 59% non-obese p=0.003) and presenting more DM and cardiovascular disease (47.9% obese versus 25.1% non obese and 41.7% versus 31.5% respectively). We did not observed differences in hemoglobin, albumin and KTV in obese patients. Concerning peritonitis rate we did not find any difference between groups, presenting more peritonitis patients on CAPD and 65 years (subhazard ratio (SHR) 1.75 (p= 0.000) and 1.56 (p=0.009)). Related to technique survival, we found higher transfer to HD in obese group in the univariate analysis that was not confirmed in the multivariate analysis (SRH 1.12 (p=0.4)), and we did not found differences in mortality rate. In relation to be transplanted, underweight group, olders and patients with cardiovascular disease or diabetic nephropathy presented less probability (SHR 0.65, 0.24. 0.5 and 0.54 p <0.05). Obese patients did not present differences in survival with weight changes, but in nonobese patients, the gain of 7% of the basal weight during the first year supposed a protective factor of dying (HR 0.6 p=0.034). CONCLUSIONS: We did not observe differences in PD adequacy parameters, technique and patient survival or probability of being transplant in obesity group. However, we found that obese patients presented more DM and cardiovascular diseases that are related to higher morbi-mortality in the multivariate analysis.

No abstract

No abstract

The object was to study the effect of oxidative factors and methods of renal replacement therapy (RRT) on indices of oxidative stress (OS) and resistance cells in blood in patients with chronic kidney disease stage V(CKD VD) and anemic syndrome. Material and methods. The study involved 47 patients with CKD VD: 14patients were treated by hemodiafiltration (HDF), 14 patients by hemodialysis (HD) and 19 patients by peritoneal dialysis (PD). The severity ofanemia was assessed according to the KDIGO (2012) criteria. The control group consisted of30 healthy people of the same age and sex. Along with the standard diagnostic methods, we defined the content of malonic dialdehyde in serum (MDAs) and in erythrocytes (MDAe), the content of ceruloplasmin (CPs), transferrin (TRs) and SH - groups in the blood serum, the index of the OS (IOS), catalase activity in serum (CTs), glucose - 6 - phosphate dehydrogenase (G - 6 - PDHe) and total peroxidase activity (TPA) in erythrocyte, osmotic (OR) and peroxide resistance (PR) of red blood cells and erythrocyte membrane permeability (EMP). Statistical analysis was performed using the programs Microsoft Excel 5,0 and MedStat. Results. It has been stated that in the CKD VD patients agains the rates in control group the MDAs content increased by 3.3 times and MDAe - 1.2 times, TRs content reduced by 34%, SH - groups - by 31%, TPAe - by 41% and G - 6 - FDGe - by 58%, marcers of OR by 30%, PR - by 60%; 4.6 times increased CTs activity and OSI; 2 times grew peroxide hemolysis (PH) and 1.3 times - EMP. The analysis (depending on the RRT modality) showed that the patients treated by HDF had typical MDAs increase by 3.9 times on a background of CPs by 24%o, TRs - 33%, SH - groups - 25%, TPAe - 51%, G6 - PDHe - 42%; the increase in serum OSI - 5.4 times and 2.6 times in erythrocytes, PR - by 3.6 times and CTs activity by 3,5 times; HD group were characterized by the highest value of MDAe, OSI, PH and CTs, along with more expressed decrease of indices TRs, SH - groups, TPA and G - 6 - FDHe activity compared with rates in patients with HDF. The patients treated with PD had the lowest content of MDAs and the highest values on the background ofTPAe, the significant increase of CPs by 1.7 times and lowest TRs and G - 6 - PDHe. The patients with PD showed twice lower OS activity by OSI. Conclusion.Thus, in patients with CKD VD, who had HD, HDF or PD an anemic syndrome was associated with high OS activity and the increased degree of hemolysis. These changes are stipulated by RRT methods: for patients receiving HDF were typical the lowest rates of hemolysis and the highest degree of protection for erythrocytes, and for patients treated with HD - the highest OS.

The aim of the research was to study the effect ofoxidative factors impact and modality of renal replacement therapy (BBT) on indices ofoxidative stress (OS) and resistance of erythrocytes membranes in patients with chronic kidney disease stage V(CKD VD) and anemie. Material and methods. The study involved 68 patients with CKD VD: 14 patients were treated by hemodiafiltration (HDF), 25 patients by hemodialysis (HD) and 29 patients by peritoneal dialysis (PD). The severity ofanemia was assessed according to the KDIGO (2012) criteria. The control group consisted of 30 healthy people of the same age and sex. Along with the standard diagnostic methods, we defined the content of malonic dialdehyde in serum (MDAs) and in erythrocytes (MDAe), the content of ceruloplasmin (CPs), transferrin (TBs) and SH-groups in the blood serum, the index of the OS (IOS), catalase activity in serum (CATs), glucose-6-phosphate dehydrogenase (G-6-PDHe) and total peroxidase activity (TPA) in erythrocyte, peroxide resistance (PR) of red blood cells and erythrocyte membrane permeability (EMP). Statistical analysis was performed using the programs of Microsoft Excel 7.0. Results. It has been stated that in the CKD VD patients in compatison with control group the MDAs content increased by 3.3 times and MDAe - 1.2 times, TBs content reduced by 34%, SH-groups - by 31%, TPAe - by 41% and G- 6-FDGe - by 58%, PB-by 60%; 4.6 times increased CATs activity and OSI; 2 times grew peroxide hemolysis (PH) and 1.3 times - EMP. The analysis (depending on the BBT modality) showed that the patients treated by HDF had typical MDAs increase by 3.9 times on a background of CPs by 24%, TBs - 33%, SH-groups - 25%, TPAe - 51%, G-6-PDHe - 42%; the increase in serum OSI - 5.4 times and 2.6 times in erythrocytes, PB - by 3.6 times and CATs activity by 3.5 times; HD group was characterized by the highest value of MDAe, OSI, PH and CATs, along with more expressed decrease of TBs indices, SH-groups, TPA and G-6-FDHe activity compared with rates in patients with HDF. The patients treated with PD had the lowest content of MDAs and the highest values on the background ofTPAe, the significant increase of CPs by 1.7 times and lowest TBs and G-6-PDHe. The patients with PD showed twice lower OS activity by OSI. Conclusion. Thus, in patients with CKD VD, who had HD, HDF or PD an anemie was associated with high OS activity and the increased degree of hemolysis. These changes are stipulated by BBT methods: for patients receiving HDF were typical the lowest rates of hemolysis and the highest degree ofprotection for erythrocytes, and for patients treated with HD - the highest OS.

No abstract