Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

Abstract

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student's t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.

Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

“…In addition, in the tissues of PD patients, diabetic or not, there is a great deposition of advanced glycation end products that predispose to the metabolic syndrome [25], a condition associated with an increased risk of cardiovascular mortality in this population [26]. Several studies demonstrated that, in PD patients, accelerated atherosclerosis processes are actively present and suggest that atherosclerosis risk is even higher in PD than in HD patients [27,28,29]. …”

Peritoneal dialysis has optimal intradialytic hemodynamics and preserves residual renal function: Why isn't it better than hemodialysis?

“…In patients with diabetes, increased peritoneal glucose absorption can worsen diabetic control 37 and separately, it has been shown that higher HbA1c levels are linked with worse outcomes. 38 Increased glucose absorption also leads to postprandial hyperglycemia (an independent risk factor for cardiovascular disease) 39 and dyslipidemia, 37,40 with a cross-sectional study reporting an association between these metabolic changes and coronary artery calcification. 41 In some patients, glucose absorption may contribute to the development of obesity, although the literature remains somewhat conflicted as to the extent of this.…”

Renal Tubular‐ and Vascular Basement Membranes and their Mimicry in Engineering Vascularized Kidney Tubules

“…On average, a kidney patient has to wait 3–4 years before transplantation. In the meantime, kidney patients have to deal with renal replacement therapies (RRTs) such as dialysis, which are only partly capable of replacing kidney function and associated with severe side effects such as cardiovascular complications . These side effects are, among others, a consequence of the insufficient clearance of uremic toxins, which are metabolic waste products that are in part coupled to plasma proteins such as albumin.…”