Comparison of changes in pulse wave velocity in patients on continuous ambulatory peritoneal dialysis and hemodialysis one year after introduction of dialysis therapy

Abstract

Damage to large arteries is a major contributory factor to the high cardiovascular morbidity and mortality of patients with end-stage renal disease. Among the methods for assessment of arterial damage, measurements of pulse wave velocity (PWV) are considered to predict cardiovascular risk. In the present study, we compared changes in the PWV of patients on hemodialysis (HD) and on continuous ambulatory peritoneal dialysis (CAPD). Patients were eligible for entry into the study if they had been on HD or CAPD for at least 3 months, but for fewer than 5 months, and if they had had no clinical cardiovascular disease during the 6 months preceding study entry. We followed a total of 22 patients (average age: 57.9 +/- 9.8 years) on HD and 22 patients (average age: 59.7 +/- 11.4 years) on CAPD for 1 year. Baseline PWV was determined, and a second measurement was performed 1 year after the baseline PWV had been obtained. Systolic and diastolic blood pressures in the two groups were similar [144.8 +/- 18.4 mmHg over 83.2 +/- 8.7 mmHg (CAPD) vs. 147.4 +/- 18.8 mmHg over 87 +/- 12.3 mmHg (HD)]. In the patients on CAPD, urine volume was fairly constant at about 546.1 +/- 365 mL daily; however, urine volume for most of the patients on HD was less than 100 mL daily. Although no significant difference was observed in baseline PWV [1726.2 +/- 374 m/s (CAPD) vs. 1774.2 +/- 531.36 m/s (HD)], a significant difference in PWV was seen between the two groups at 1 year [1631.9 +/- 380.8 m/s (CAPD) vs. 1853.2 +/- 434.2 m/s (HD), p < 0.05]. With the exception of level of serum cholesterol [256 + 24 mg/dL (CAPD) vs. 187 + 25 mg/dL (HD), p < 0.05], other laboratory data were not significantly different between the two groups. Despite higher serum cholesterol in the patients on CAPD, PWV was faster in the patients on HD. There may be less arterial damage in patients on CAPD than in patients on HD.