I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on July 31, 2010, 08:06:25 PM
-
Review
Nature Reviews Nephrology 6, 451-460 (August 2010) | doi:10.1038/nrneph.2010.68
Subject Categories: Risk factors and epidemiology | Dialysis (hemodialysis, peritoneal dialysis, continuous renal replacement)
Cardiovascular risk in the peritoneal dialysis patient
Raymond T. Krediet & Olga Balafa About the authors
Top of page
Abstract
Cardiovascular death is the most frequent cause of death in patients on peritoneal dialysis. Risk factors for cardiovascular death in these patients include those that affect the general population as well as those related to end-stage renal disease (ESRD) and those that are specific to peritoneal dialysis. The development of overhydration after loss of residual renal function is probably the most important cardiovascular risk factor specific to peritoneal dialysis. The high glucose load associated with peritoneal dialysis may lead to insulin resistance and to the development of an atherogenic lipid profile. The presence of glucose degradation products in conventional dialysis solutions, which leads to the local formation of advanced glycation end products, is also specific to peritoneal dialysis. Other risk factors that are not specific to peritoneal dialysis but are related to ESRD include calcifications and protein-energy wasting. When present together with inflammation and atherosclerosis, protein-energy wasting is associated with a marked increase in the risk of cardiovascular death. Obesity is not associated with increased cardiovascular risk in patients on any form of dialysis. Left ventricular hypertrophy and increased arterial stiffness are the most important risk factors for cardiovascular events in the general population.
For complete article go to http://www.nature.com/nrneph/journal/v6/n8/full/nrneph.2010.68.html