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

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.

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Factors associated with increased pulse wave velocity in peritoneal dialysis patients

Open Medicine ◽

10.2478/s11536-010-0014-9 ◽

2010 ◽

Vol 5 (3) ◽

pp. 381-386 ◽

Cited By ~ 2

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.

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Aortic-Brachial Stiffness Mismatch and Mortality in Peritoneal Dialysis Patients

Kidney & Blood Pressure Research ◽

10.1159/000498876 ◽

2019 ◽

Vol 44 (1) ◽

pp. 123-132 ◽

Cited By ~ 1

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.

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Bioimpedance Spectroscopy for the Detection of Fluid Overload in Chinese Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00066 ◽

2014 ◽

Vol 34 (4) ◽

pp. 409-416 ◽

Cited By ~ 25

Author(s):

Bonnie Ching-Ha Kwan ◽

Cheuk-Chun Szeto ◽

Kai-Ming Chow ◽

Man-Ching Law ◽

Mei Shan Cheng ◽

...

Keyword(s):

Blood Pressure ◽

Peritoneal Dialysis ◽

Arterial Stiffness ◽

Nutritional Status ◽

Pulse Wave Velocity ◽

Serum Albumin ◽

Pulse Wave ◽

Fluid Overload ◽

Bioimpedance Spectroscopy ◽

Dialysis Adequacy

BackgroundFluid overload probably contributes to the cardiovascular risk of peritoneal dialysis (PD) patients. We studied the relationship between over-hydration as determined by bioimpedance spectroscopy and dialysis adequacy, nutritional status, and arterial stiffness in Chinese PD patients.MethodsWe studied 122 asymptomatic prevalent PD patients: bioimpedance spectroscopy, arterial pulse wave velocity, dialysis adequacy and nutritional status were determined.ResultsOf the 122 patients, 88 (72.1%) had over-hydration of ≥ 1 L, while 25 (20.5%) were ≥ 5 L. Over-hydration significantly correlated with total body water (r = 0.474, p < 0.001) and extracellular water (r = 0.755, p < 0.001). Over-hydration was more severe in male and diabetic patients, and significantly correlated with Charlson's comorbidity score, blood pressure, body mass index, body weight, peritoneal transport characteristics, and carotid-femoral pulse wave velocity. Over-hydration significantly correlated with Kt/V (r = -0.287, p = 0.016), serum albumin level (r = -0.465, p < 0.001) and malnutrition inflammation score (r = 0.410, p = 0.006), but not residual renal function.ConclusionOver-hydration is common in asymptomatic Chinese PD patients. The degree of over-hydration is particularly pronounced in patients who are inadequately dialyzed, have multiple comorbid conditions and low serum albumin levels. Over-hydration is associated with high blood pressure and arterial stiffness, and may contribute to the excessive risk of cardiovascular disease in this group of patients.

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

Peritoneal Dialysis International ◽

10.1177/089686080802800621 ◽

2008 ◽

Vol 28 (6) ◽

pp. 668-672 ◽

Cited By ~ 9

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.

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Association Between White Blood Cell Counts and Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults: A Cross-Sectional Study

Angiology ◽

10.1177/00033197211021199 ◽

2021 ◽

pp. 000331972110211

Author(s):

Buyun Jia ◽

Chongfei Jiang ◽

Yun Song ◽

Chenfangyuan Duan ◽

Lishun Liu ◽

...

Keyword(s):

Arterial Stiffness ◽

Blood Cell ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

White Blood Cell ◽

Pulse Wave ◽

Final Analysis ◽

Cross Sectional ◽

Cell Counts ◽

Wbc Count

Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.

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Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults

Scientific Reports ◽

10.1038/s41598-021-89639-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ji-Hee Haam ◽

Young-Sang Kim ◽

Doo-Yeoun Cho ◽

Hyejin Chun ◽

Sang-Woon Choi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Cardiovascular Risk Factors ◽

Wave Velocity ◽

Pulse Wave ◽

Urinary Metabolites ◽

Metabolic Disturbances ◽

Liquid Chromatograph

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.

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Gut microbiota composition and arterial stiffness measured by pulse wave velocity: case–control study protocol (MIVAS study)

BMJ Open ◽

10.1136/bmjopen-2020-038933 ◽

2021 ◽

Vol 11 (2) ◽

pp. e038933

Author(s):

Rita Salvado ◽

Sandra Santos-Minguez ◽

Cristina Agudo-Conde ◽

Cristina Lugones-Sanchez ◽

Angela Cabo-Laso ◽

...

Keyword(s):

Arterial Stiffness ◽

Gut Microbiota ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Intestinal Microbiota ◽

Pulse Wave ◽

Case Control Study ◽

Case Control ◽

Microbiota Composition ◽

Control Study

IntroductionIntestinal microbiota is arising as a new element in the physiopathology of cardiovascular diseases. A healthy microbiota includes a balanced representation of bacteria with health promotion functions (symbiotes). The aim of this study is to analyse the relationship between intestinal microbiota composition and arterial stiffness.Methods and analysisAn observational case—control study will be developed. Cases will be defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), Cardio-Ankle Vascular Index (CAVI), brachial ankle pulse wave velocity (ba or ba-PWV) above the 90th percentile, for age and sex, of the reference population. Controls will be selected from the same population as cases. The study will be developed in Primary Healthcare Centres. We will select 500 subjects (250 cases and 250 controls), between 45 and 74 years of age. Cases will be selected from a database that combines data from EVA study (Spain) and Guimarães/Vizela study (Portugal). Measurements: cf-PWV will be measured using the SphygmoCor system, CAVI, ba-PWV and Ankle-Brachial Index will be determined using VaSera device. Gut microbiome composition in faecal samples will be determined by 16S ribosomal RNA sequencing. Lifestyle will be assessed by food frequency questionnaire, adherence to the Mediterranean diet and IPAQ (International Physical Activity Questionnaire). Body composition will be evaluated by bioimpedance.Ethics and disseminationThe study has been approved by ‘Committee of ethics of research with medicines of the health area of Salamanca’ on 14 December 2018 (cod. 2018-11-136) and the ’Ethics committee for health of Guimaraes’ (Portugal) on 15 October 2019 (ref: 67/2019). All study participants will sign an informed consent form agreeing to participate in the study, in compliance with the Declaration of Helsinki and the WHO standards for observational studies. The results of this study will allow a better description of gut microbiota in patients with arterial stiffness.Trial registration detailsClinicalTrials.gov, identifier NCT03900338

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