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

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

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

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

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Background: The natural history of AA amyloidosis is typically progressive, leading to multiple organ failure and death. We analyzed the etiology as well as clinical and laboratory features of patients with biopsy-proven AA amyloidosis and evaluated the ultimate outcome. Methods: Seventy-three patients (24 female; mean age 41.85±15.89 years) were analyzed retrospectively. Demographic, clinical and laboratory features were studied and the outcome was assessed. Results: Familial Mediterranean Fever and tuberculosis were the most frequent causes of amyloidosis. Mean serum creatinine and proteinuria at diagnosis were 4.65±4.89 mg/dl and 8.04±6.09 g/day, respectively; and stage I, II, III, IV and V renal disease were present in 19.2%, 13.7%, 16.4%, 11%, and 39.7% of the patients, respectively. ESRD developed in 16 patients during the follow-up period. All of the ESRD patients started a dialysis programme. Thirty patients (41%) died during the follow-up period; median patient survival was 35.9±6.12 months. Old age, tuberculosis etiology, advanced renal disease and low serum albumin levels were associated with a worse prognosis. Serum albumin was a predictor of mortality in logistic regression analysis. Conclusion: The ultimate outcome of the patients with AA amyloidosis is poor, possibly due to the late referral to the nephrology clinics. Early referral may be helpful to improve prognosis

Decreased Serum 25-hydroxyvitamin D Level Causes Interventricular Septal Hypertrophy in Patients on Peritoneal Dialysis: Cardiovascular Aspects of Endogenous Vitamin D Deficiency

Introduction. In the present study, we aimed to analyze the relation of vitamin D with echocardiographic indexes in patients with end stage renal disease (ESRD) receiving renal replacement therapy (RRT). Methods. A total of 98 patients, 64 patients on hemodialysis (HD) (29F/35M, mean age 56.75 +/- 18.63 years) and 34 age matched patients on peritoneal dialysis (PD) (21F/13M, mean age 58.11 +/- 10.63 years), with similar duration of ESRD and RRT were enrolled into this cross-sectional study. Echocardiographic examination was performed after dialysis session at normovolemic status. Fasting blood samples were obtained before dialysis session. Results. Patients on PD and female patients in both groups had significantly lower level of 25-OH-D3 level when compared to patients on HD or male patients (p: 0.0001 and p: 0.0001). When all participants were considered, there was no significant association between 25-OH-D3 and echocardiographic parameters; however, in patients on PD, a significant negative correlation was determined between 25-OH-D3 and diastolic blood pressure, interventricular septal hypertrophy (ISH), and left ventricular mass index (LVMI) (r: -0.424, p: 0.012; r: -0.508, p: 0.004; r: 0.489, p: 0.04, resp.). Conclusion. Low serum 25-hydroxyvitamin D levels is associated with ISH and LVMI in PD patients

Decreased Serum 25-hydroxyvitamin D Level Causes Interventricular Septal Hypertrophy in Patients on Peritoneal Dialysis: Cardiovascular Aspects of Endogenous Vitamin D Deficiency

Introduction. In the present study, we aimed to analyze the relation of vitamin D with echocardiographic indexes in patients with end stage renal disease (ESRD) receiving renal replacement therapy (RRT). Methods. A total of 98 patients, 64 patients on hemodialysis (HD) (29F/35M, mean age 56.75 ± 18.63 years) and 34 age matched patients on peritoneal dialysis (PD) (21F/13M, mean age 58.11 ± 10.63 years), with similar duration of ESRD and RRT were enrolled into this cross-sectional study. Echocardiographic examination was performed after dialysis session at normovolemic status. Fasting blood samples were obtained before dialysis session. Results. Patients on PD and female patients in both groups had significantly lower level of 25-OH-D3 level when compared to patients on HD or male patients (p: 0.0001 and p: 0.0001). When all participants were considered, there was no significant association between 25-OH-D3 and echocardiographic parameters; however, in patients on PD, a significant negative correlation was determined between 25-OH-D3 and diastolic blood pressure, interventricular septal hypertrophy (ISH), and left ventricular mass index (LVMI) (r: −0.424, p: 0.012; r: −0.508, p: 0.004; r: 0.489, p: 0.04, resp.). Conclusion. Low serum 25-hydroxyvitamin D levels is associated with ISH and LVMI in PD patients

Comparison of serum paraoxonase and arylesterase activities between iron deficiency anemia patients and chronic kidney disease patients with anemia

Objective: Altered paraoxonase (PON) and arylesterase (ARE) activities have been shown in anemic chronic kidney disease (CKD) patients and in iron deficiency anemia (IDA) patients. Whether accompanying anemia alone is responsible for this diminished PON and ARE activities in CKD patients or an additive factor for this is not well studied. Therefore, we tried to clarify this issue here. Methods: A total of 82 subjects that consisted of 19 patients with IDA (group 1), 23 anemic CKD patients (group 2), and 40 age and sex matched healthy subjects (group 3) were enrolled. Carotid intima media thickness (CIMT), serum total thiol (-SH), PON, and ARE activities of the participants were analyzed. Results: Group 2 patients had significantly lowest serum levels of Total -SH, PON and ARE. Further comparison showed that total -SH, PON and ARE levels were lower in group 1 than group 3 (p=0.0001 in both). Regarding comparison of group 1 and 2, only serum ARE levels were significantly lower in group 2 (p=0.001). PON activity was not different between group 1 and group 2 whereas ARE activity was lower in group 2 than groups 1 and 3. In addition, correlation analysis showed that CIMT was negatively correlated with PON and ARE. Conclusions: This markedly decreased ARE activity in CKD patients, which could not be explained by the anemia alone, may have a role in the pathogenesis of increased atherosclerosis in such patients. Still further studies are needed to certain this