Relationship between Inflammatory Markers and High Resolution B-mode Carotid Artery Ultrasonography in Continuous Ambulatory Peritoneal Dialysis(CAPD) Patients.
- Author:
Hyun Yong SONG
1
;
Young Soo SONG
;
Chul Woo AHN
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Sung Kyu HA
;
Hyun Chul LEE
;
Ho Yung LEE
;
Dae Suk HAN
Author Information
1. Department of Internal Medicine, College of Medicine, Konyang University, Korea. hysong@kyuh.co.kr
- Publication Type:Original Article
- Keywords:
Continuous ambulatory peritoneal dialysis;
Albumin;
C-reactive protein;
Carotid artery intima-media thickness;
atherosclerosis
- MeSH:
Atherosclerosis;
C-Reactive Protein;
Cardiovascular Diseases;
Carotid Arteries*;
Coronary Artery Disease;
Humans;
Inflammation;
Logistic Models;
Mortality;
Peritoneal Dialysis, Continuous Ambulatory;
Prevalence;
Risk Factors;
Serum Albumin;
Ultrasonography*
- From:Korean Journal of Nephrology
2002;21(2):285-294
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. METHODS: To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. RESULTS: Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79+/-0.21 mm vs. 0.60+/-0.11 mm, p < 0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p < 0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67+/-0.15 mm vs 0.61+/-0.12 mm, p < 0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p < 0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p < 0.05). Patients with high CRP(>or=0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p < 0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. CONCLUSION: Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease.
