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. 2018 Dec 4:9:1743.
doi: 10.3389/fphys.2018.01743. eCollection 2018.

Peritoneal Dialysis Is an Independent Factor Associated to Lower Intima Media Thickness in Dialysis Patients Free From Previous Cardiovascular Disease

Mercè Borràs  1   2 , Serafí Cambray  1 , Maria Crespo-Masip  1 , Miguel Pérez-Fontán  3 , Milica Bozic  1 , Marcelino Bermudez-López  1 , Elvira Fernández  1   2 , Àngels Betriu  1 , José M Valdivielso  1
Affiliations

Peritoneal Dialysis Is an Independent Factor Associated to Lower Intima Media Thickness in Dialysis Patients Free From Previous Cardiovascular Disease

Mercè Borràs et al. Front Physiol. .

Abstract

Carotid intima media thickness (cIMT) displays prognostic value as a marker of cardiovascular risk in dialysis patients. However, few data are available regarding the impact of dialysis modality on cIMT. The aim of this study is to determine whether the modality of dialysis influences cIMT values. We compared 237 peritoneal dialysis (PD) and 451 hemodialysis (HD) patients without previous cardiovascular disease included in NEFRONA, a prospective, observational and multicenter study. This cross sectional study included the determination of cIMT in 6 carotid territories by arterial ultrasound. cIMT was determined in territories without atheroma plaque and averaged. A second analysis was performed using all territories, giving a truncated cIMT value of 1,5 mm to territories presenting with atheroma plaque. Age and plaque presence at baseline were the clinical variables more closely associated to cIMT in dialysis patients. The evaluation of the impact of the modality of dialysis on cIMT showed that PD patients had lower cIMT than HD patients, both in territories with no plaques and when using truncated cIMT values. No differences were found between right and left sides, neither in cIMT or truncated cIMT values. Lineal multivariate analysis adjusted by several clinical variables showed a statistically significant association of PD with a lower cIMT (slope -0.036; SD 0.010). These results were also confirmed when truncated cIMT values were used. We conclude that the modality of dialysis has an impact on cITM. HD patients have greater global cIMT than PD patients, and PD is and independent factor associated with a lower cIMT.

Keywords: atherosclerosis; cohorts study; dialysis; intima and media thickness; ultrasound.

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Figures

FIGURE 1
FIGURE 1
Averaged intima media thickness in carotid arterial territories depending on the dialysis modality. (A) Excluding territories with atheroma plaque; (B) Including territories with atheroma plaque. In territories with plaque, the IMT value was truncated to 1,5 mm.
FIGURE 2
FIGURE 2
Averaged intima media thickness in carotid arterial territories stratified by age and sex. Dark bars: Males; White bars: Females. (A) Excluding territories with atheroma plaque; (B) Including territories with atheroma plaque. In territories with plaque, the IMT value was truncated to 1,5 mm. p trend > 0,01.
FIGURE 3
FIGURE 3
Averaged intima media thickness in carotid arterial territories stratified by side. Dark bars: HD patients; White bars: PD patients. (A) Excluding territories with atheroma plaque; (B) Including territories with atheroma plaque. In territories with plaque, the IMT value was truncated to 1,5 mm.
See this image and copyright information in PMC

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