Baseline carotid intima‐media thickness is associated with cardiovascular morbidity and mortality in peritoneal dialysis patients

Abstract

Carotid intima-media thickness (CIMT) is an early marker of atherosclerosis and is increased in peritoneal dialysis (PD) patients. Association of CIMT with cardiovascular disease (CVD) or mortality is less clear. Fibroblast growth factor-23 (FGF-23) is a hormone associated with vascular calcification, atherosclerosis, and mortality in the hemodialysis population. We investigated whether baseline CIMT and FGF-23 are associated with CVD and mortality in PD patients. Fifty-five PD patients were included. CVD was defined as ischemic heart disease, stroke, or peripheral artery disease. Intact FGF-23 was measured in plasma. CIMT was measured by ultrasonography. Twenty-one patients developed CVD and 12 died over 47.1 ± 33.8 months. Patients with CVD were older (55.9 ± 10.5 vs. 42.5 ± 12.9 years, P < .01), had lower albumin (3.8 ± 0.5 vs. 4.2 ± 0.3 g/dL, P < .01) and higher CIMT (0.87 ± 0.22 vs. 0.61 ± 0.11 mm, P < .01). Patients with mortality were also older (53.5 ± 11.5 vs. 45.8 ± 13.8 years, P = .05), had lower albumin (3.7 ± 0.6 vs. 4.1 ± 0.3 g/dL, P < .01), higher CRP (15.0 ± 8.5 vs. 7.6 ± 8.4 mg/L, P < .01) and CIMT (0.9 ± 0.3 vs. 0.6 ± 0.1 mm, P < .01). Albumin and CIMT were associated with CVD and CIMT > 0.75 mm was associated with cardiovascular mortality. FGF-23 did not show any correlations. CIMT at baseline is associated with CVD and mortality in PD patients.

Serum fibroblast growth factor 23 concentration and the risk of mortality in patients undergoing peritoneal dialysis

“…27 –29 It has been consistently shown that the FGF23 concentrations are increased in PD patients, but conflicting results have been obtained with respect to the relationship between high FGF23 and the risk of major adverse cardiac and cerebral events. 13,14 It has been shown that there is no significant association of FGF23 with all-cause 30 or CVD-related mortality 31 in PD patients, which was similar with our study. There may be several explanations for the discrepancies between the results of these studies.…”

Arterial calcifications and osteoprotegerin in chronic hemodialysis patients: impact on 6-year survival

“…Ultrasound, as one of the most valuable and, also available tool, can easily detect morphological abnormalities of the vascular walls. Discrete modi cations of carotid intima media thickness increase cardiovascular mortality in peritoneal dialysis patients 12 . Different scoring of AMC realized on ultrasound exam of the lower limbs was associated with chronic complications of diabetes mellitus, especially the nephropathy 13 .…”

Relation between carotid intimal medial thickness and left ventricular mass and left ventricular mass indices in maintenance hemodialysis patients

“…Increased carotid intimal media thickness (CIMT) measured by B-mode ultrasound is regarded as a measure of generalized atherosclerosis [6]. CIMT was found to be associated with cardiovascular disease (CVD) as CIMT > 0.75 mm was associated with cardiovascular mortality, and CIMT at baseline is associated with CVD and mortality in PD patients [7]. Parallel relationships have been demonstrated between CIMT and LVM in population studies [8] and are particularly well documented in hypertensive populations [9].…”