Cardiac, Inflammatory and Metabolic Parameters: Hemodialysis versus Peritoneal Dialysis

Lai, Silvia; Molfino, Alessio; Russo, Gaspare Elios; Testorio, Massimo; Galani, Alessandro; Innico, Georgie; Frassetti, Nicla; Pistolesi, Valentina; Morabito, Santo; Fanelli, Filippo Rossi

doi:10.1159/000369588

Cited by 24 publications

(21 citation statements)

References 52 publications

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“…Clinical and instrumental examinations of HD patients were performed during the middle of the week, after HD treatment, while PD patients were examined before the first replacement of the morning with an empty peritoneum at routine visits. [10] …”

Section: Methodsmentioning

confidence: 99%

Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

Lai¹,

Mecarelli²,

Pulitano³

et al. 2016

Medicine

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Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy.Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled. Clinical, laboratory, and instrumental examinations, as renal function, inflammation and mineral metabolism indexes, electroencephalogram (EEG), psychological (MMPI-2, Sat P), and cognitive tests (neuropsychological tests, NPZ5) were carried out.The results showed a significant differences in the absolute and relative power of delta band and relative power of theta band of EEG (P = 0.008, P < 0.001, P = 0.051), a positive correlation between relative power of delta band and C-reactive protein (CRP) (P < 0.001) and a negative correlation between estimated glomerular filtration rate (eGFR) (P < 0.001) and 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) (P < 0.001), in all the samples. Qualitative analysis of EEG showed alterations of Grade 2 (according to Parsons–Smith classification) in patients on conservative therapy, and Grade 2–3 in KT patients. The scales of MMPI-2 hysteria and paranoia, are significantly correlated with creatinine, eGFR, serum nitrogen, CRP, 1,25-(OH)2D3, intact parathyroid hormone (iPTH), phosphorus, and cynical and hysterical personality, are correlated with higher relative power of delta (P = 0.016) and theta band (P = 0.016). Moreover, all NPZ5 scores showed a significant difference between the means of nephropathic patients and the means of the HC, and a positive correlation with eGFR, serum nitrogen, CRP, iPTH, and vitamin D.In CKD patients, simple and noninvasive instruments, as EEG, and cognitive-psychological tests, should be performed and careful and constant monitoring of renal risk factors, probably involved in neuropsychological complications (inflammation, disorders of mineral metabolism, electrolyte disorders, etc.), should be carried out. Early identification and adequate therapy of neuropsychological, and cognitive disorders, might enable a better quality of life and a major compliance with a probable reduction in the healthcare costs.

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Section: Methodsmentioning

confidence: 99%

Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

Lai¹,

Mecarelli²,

Pulitano³

et al. 2016

Medicine

Self Cite

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“…The hemodynamic consequences of VC include loss of arterial elasticity, increase in PWV, development of left ventricular hypertrophy, decrease in coronary artery perfusion, and myocardial ischemia [28] in association with higher serum levels of OPG [29] in PD patients. Moreover, progressors had higher CTR values than nonprogressors in the present study.…”

Section: Discussionmentioning

confidence: 99%

Aortic Arch Calcification and Bone-Associated Molecules in Peritoneal Dialysis Patients

et al. 2019

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Background/Aims: Aortic arch calcification (AoAC) is a fatal complication in dialysis. AoAC progression-related molecules in continuous ambulatory peritoneal dialysis (CAPD) remain unclear. Methods: AoAC was estimated using plain chest radiography scoring (AoACS) in 30 CAPD patients (age 49.3 ± 13.4 years). AoAC progression was defined as increased AoACS on follow-up chest X-ray at the end of the study (progressors). Fibroblast growth factor-23 and osteoprotegerin (OPG) were measured. Results: Median follow-up was 38.5 months. Progressors were older, had shorter PD vintage, higher body mass index, and higher serum OPG levels (255.6 ± 109.2 pg/mL) than nonprogressors (183.4 ± 68.2 pg/mL; p = 0.0400). Progressors also showed higher pulse pressure (62.4 ± 20.0 mm Hg) and pulse wave velocity (1,909.9 ± 310.6 cm/s) than nonprogressors (48.5 ± 13.6 mm Hg; p = 0.0030 and 1,390.1 ± 252.8 cm/s; p = 0.0005, respectively). Conclusion: AoAC progression was associated with increased aortic stiffness. OPG may be associated with AoAC progression in CAPD.

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“…There are several co-morbidities in dialysis patients, such as DM, hypertension, anemia, malnutrition and chronic inflammation; fluid status may also contribute to cardiomegaly202122. Moreover, reduced ABI is associated with PAOD2324 and secondary to DM, smoking, hypertension, advanced age and hyperlipidemia25.…”

Section: Discussionmentioning

confidence: 99%

Association between peripheral arterial occlusive disease and cardiothoracic ratio in patients on chronic hemodialysis

Liou¹,

Liou

Fang

et al. 2016

Sci Rep

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The cardiothoracic ratio (CTR) and peripheral arterial occlusive disease (PAOD) are related to mortality in hemodialysis patients. However, data on the association between PAOD and CTR are limited. In this study, we aim to elucidate this relationship in patients on chronic hemodialysis. Using a retrospective cross-sectional study of 622 Taiwanese patients, we investigated the association of PAOD and CTR. PAOD was significantly associated with CTR in the crude analysis. The odds ratio (OR) for CTR >0.5 was 1.77 [95% confidence interval (CI), 1.32–2.37], and the odds ratio for CTR >0.6 was 2.18 [95% CI, 1.44–3.30]. After adjusting for confounding variables, this difference continued to exhibit significant predictive power for CTR >0.6 (OR, 1.88; 95% CI, 1.14–3.11), but the predictive power for CTR >0.5 was attenuated (OR, 1.41; 95% CI, 0.98–2.03). In the subgroup analysis, PAOD was an independent factor for CTR >0.6, particularly in elderly and female patients or patients with hemoglobin >10 mg/dl and with no history of cardiovascular disease. In this research, we showed that the detection of PAOD was independently associated with CTR >0.6 in patients on chronic hemodialysis.

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Cardiac, Inflammatory and Metabolic Parameters: Hemodialysis versus Peritoneal Dialysis

Cited by 24 publications

References 52 publications

Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

Aortic Arch Calcification and Bone-Associated Molecules in Peritoneal Dialysis Patients

Association between peripheral arterial occlusive disease and cardiothoracic ratio in patients on chronic hemodialysis

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