Bone Mineral Density, Vascular Calcifications, and Arterial Stiffness in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (6) ◽  
pp. 668-672 ◽  
Author(s):  
Teresa Adragao ◽  
Patrícia Branco ◽  
Rita Birne ◽  
José Dias Curto ◽  
Edgar de Almeida ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Dialysis Patients ◽  
Mineral Density ◽  
Vascular Calcifications ◽  
Calcification Score

The objective of this study was to evaluate the correlation of bone mineral density (BMD), evaluated by DXA, with vascular calcifications, arterial stiffness, and vascular disease in patients on peritoneal dialysis. Vascular calcifications were evaluated by vascular calcification score on plain x ray, and arterial stiffness was measured by pulse wave velocity using the Complior device (Artech Medical, Pantin, France). Adjusting for multiple factors, lower BMD at the femoral neck, but not at the lumbar spine, was associated with higher pulse wave velocity ( p = 0.037), higher vascular calcification score ( p = 0.013), and peripheral artery disease ( p = 0.006). These data reinforce the hypothesis of the existence of a link between bone disease and cardiovascular disease in dialysis patients.

scholarly journals Aortic-Brachial Stiffness Mismatch and Mortality in Peritoneal Dialysis Patients

2019 ◽  
Vol 44 (1) ◽  
pp. 123-132 ◽  
Author(s):  
WenHan Bao ◽  
FangYu Wang ◽  
Wen Tang
Keyword(s):  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Cox Regression ◽  
Dialysis Patients ◽  
Cox Regression Analysis ◽  
Cvd Mortality

Background/Aims: Possible predictive value of aortic-brachial arterial stiffness mismatch assessed by pulse wave velocity PWV ratio in peritoneal dialysis patients’ outcomes need to be further elucidated. The aim of this study is to investigate the predictor value of PWV ratio on peritoneal dialysis (PD) patients’ outcomes in China. Methods: In this longitudinal cohort study, patients who started PD during September 20, 2005, to February 05, 2008, were included. All the patients were followed until January 31, 2018. Aortic-brachial arterial stiffness mismatch was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity (PWV ratio). Results: A total of 181 incident PD patients were included. The median survival of patients in PWV ratio above median group (4.03 years, 95% CI 4.64-7.99 years) was shorter than that of PWV ratio below median group (10.43 years, 95% CI 9.74-11.12 years, p< 0.001). The cardiovascular mortality rate in PWV ratio above median group were significantly higher than that of PWV below median group (log rank test, p< 0.001). Univariate Cox regression analysis showed that both PWV ratio (HR 2.42, 95% CI 1.80-3.25, p< 0.001) and CF-PWV (HR 1.27, 95% CI 1.16-1.38, p< 0.001) were associated with high patients’ all-cause mortality. Multivariable Cox regression analysis showed that the PWV ratio was a strong and significantly predictor of cardiovascular mortality (HR 2.08 95% CI 1.16-3.71, p=0.014) after adjusting for coronary heart disease history (HR 2.39, 95% CI 1.20-4.76, p=0.013), diabetes mellitus history (HR 2.84, 95% CI 1.51-5.33, p=0.001). However, the CF-PWV was failed to be included as a significant predictor for both all-cause and CVD mortality in the multivariable Cox regression model. Conclusion: Aortic-brachial arterial stiffness mismatch as assessed by PWV ratio, a new arteries stiffness risk parameter, is a significant prognostic indicator of CVD mortality in PD patients. We demonstrated that the discriminative power of the PWV ratio for both all-cause and CVD mortality was better than that CF-PWV.

Factors associated with increased pulse wave velocity in peritoneal dialysis patients

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 381-386 ◽  
Author(s):  
Paweł Stróżecki ◽  
Rafał Donderski ◽  
Magdalena Grajewska ◽  
Elżbieta Marcinkowska ◽  
Michał Kozłowski ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Peritoneal Transport

AbstractElevated pulse wave velocity (PWV) reflects increased arterial stiffness. Several studies have investigated PWV in peritoneal dialysis (PD) patients, but direct comparisons with healthy controls were not done. The potential influence of peritoneal transport characteristics on arterial stiffness in PD patients was suggested in recent studies. The aims of this study were to compare PWV in PD patients and healthy volunteers, and to investigate factors associated with increased PWV. The carotid-femoral PWV was measured in 28 PD patients and 28 healthy controls, matched for age and gender. A peritoneal equilibration test (PET) was performed in all PD patients. Based on the PET, patients were classified as: high transporters (H) (n=8), high-average (HA) (n=12), low-average (LA) (n=6), and low transporters (L) (n=2). Six of the PD patients were diabetic. PWV was significantly higher in the PD patients than in the controls (9,9±2,4 vs. 8,0±0,9; p=0,0004). In the PD group, PWV was higher in H/HA than in L/LA patients (10,4 ± 2,5 vs. 8,6 ± 1,0; p=0,008), but all the diabetic patients were in the H/HA group. PWV was significantly higher in diabetic than in non-diabetic PD patients (12,8 ± 2,0 vs. 9,1 ± 1,7; p=0,004). In the PD patients, significant positive correlations were found between PWV and: age, pulse pressure, Kt/V, and duration of PD therapy. In conclusion, the carotid-femoral PWV is elevated in peritoneal dialysis patients. Increased PWV in PD patients is associated with age, diabetic status, and longer duration of PD therapy, but not with this type of peritoneal transport.

Arterial Pulse Wave Velocity and Peritoneal Transport Characteristics Independently Predict Hospitalization in Chinese Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Ni Gao ◽  
Bonnie Ching-Ha Kwan ◽  
Kai-Ming Chow ◽  
Kwok-Yi Chung ◽  
Wing-Fai Pang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Fluid Overload ◽  
Technique Survival ◽  
Cardiothoracic Ratio ◽  
Peritoneal Transport ◽  
Duration Of Hospitalization

ObjectiveCardiovascular disease (CVD) is the most common cause of mortality in chronic peritoneal dialysis (PD) patients. Increased arterial stiffness may be related to a high peritoneal permeability resulting in fluid overload in PD patients. We studied the relations between arterial stiffness, peritoneal transport, and radiographic parameters of systemic fluid overload in a cohort of Chinese PD patients.DesignProspective cohort study.SettingUniversity referral center.PatientsWe studied 107 PD patients. Vascular pedicle width and cardiothoracic ratio were measured from a plain postero-anterior chest radiograph. Pulse wave velocity (PWV) was determined at carotid–femoral (C-F) and carotid–radial sites. Peritoneal transport was determined by the dialysate-to-plasma ratio (D/P) of creatinine at 4 hours of dwell. Patients were followed for 9.4 ± 4.6 months.Outcome MeasuresDuration of hospitalization; actuarial and technique survival.ResultsThere were no relationships between radiographic measures, arterial PWV, and D/P creatinine. However, both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. None of the parameters correlated with mortality in this study.ConclusionsThere were no relationships between radiological parameters of fluid overload, peritoneal transport characteristics, and arterial PWV. Both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. Our result suggests that arterial stiffness and high peritoneal transport each contribute to the development of CVD in this group of patients.

scholarly journals Reduction in Aortic Pulse Wave Velocity Is Associated with a Short-Term Reduction in Dual-Energy X-Ray Absorptiometry Lumbar Spine Bone Mineral Density T Score

2019 ◽  
Vol 48 (4) ◽  
pp. 346-350
Author(s):  
Kamonwan Tangvoraphonkchai ◽  
Andrew Davenport
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Pulse Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Vascular Stiffness ◽  
Dialysis Patients ◽  
Mineral Density ◽  
T Score

Introduction: Increased vascular stiffness is a risk factor for mortality. We wished to determine whether changes in vascular stiffness are associated with changes in bone mineral density (BMD) in peritoneal dialysis patients. Methods: We measured vascular stiffness by aortic pulse wave velocity (aPWV) and BMD by dual electron absorptiometry (DXA) scanning and compared T scores to compensate for differences in patient ages and gender. Results: Twenty-four patients had repeat aPWV measurements and DXA scans, median 12.4 months apart. aPWV decreased in 15 and increased in 9. As there were more women in the group with an increase in aPWV, we used gender-adjusted DXA T scores Total body T scores fell in both groups, but median T scores remained positive for those with an increase in aPWV, whereas negative T scores on both scans for those with a decrease in or stable aPWV. Lumbar spine T scores fell in those with a reduction in aPWV (–1.6 [–2.4 to 0.6] to –2.1 [–2.4 to 0.3], p < 0.05), whereas there was no significant decrease in those with an increase in aPWV (–0.5 [–1.1 to 0.15] to –0.7 [–1.7 to 0.6]). There were no changes in femoral neck T scores. Conclusions: Our study reinforces the hypothesis of a link between bone disease and vascular disease in dialysis patients. Lumbar spine DXA includes imaging of the aorta and will include aortic calcification, and as such a reduction in lumbar spine T score without a change in femoral neck T score suggests a reduction in aortic calcification. Although our study requires additional confirmation, our data would suggest that changes in aPWV could be used as a surrogate for changes in vascular calcification in the investigation of interventions designed to reduce vascular calcification.

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