Sustained Volume Overload Was Associated With Increased In Stiffness Of Great Artery In Continuous Ambulatory Peritoneal Dialysis Patients

Objectives:(1) To investigate the relationship between continuous volume overload and large arterial stiffness in Patients on CAPD. (2) Further to find the possible mechanisms making stiffer arterial stiffness in CAPD patients.Methods:Clinical stable CAPD patients (n=220,86M/134F)in one single center were included. The patients were evaluated by volume load every month during six months in a longitudinal study. According to the volume status, the patients were divided into normal volume load group 94 (normal group),incontinuous over volume load group 79 (incontinuous group) and continuous over volume load group 47(continuous group) respectively. Multiple-frequency bioelectrical impedance analysis was used to record volume load status。Carotid-femoral PWV was measured with a validated automatic device and was used as an index of large arterial stiffness。In addition, some biochemical indices, such as serum albumin,hypersensitive C-reactive Protein,serum creatinine, etc, were determined with standard methods. At last, it was important to analyse the change of large arterial stiffness before and after six months. Ap-value<0.05 was considered statistically significant.Results:All patients completed the study[male/female(86:134)].94 were classified as normal volume (NV),79 intermittent volume overload (IVO)and 47 sustained volume overload(SVO).At baseline, the systolic blood pressure(SBP) was significantly higher in sustained volume overload[SVO(144.8±20.9) vs IVO (135.5±23.4) vs NV (127.0±23.9) mmHg, P<0.05 or P<0.01];After six months, systolic blood pressure remained Significant[SVO(144.4±22.0) vs IVO (136.8±24.5) vs NV (130.0±26.0) mmHg, P<0.05 or P<0.01]. PWV in both the SVO and IVO were significant higher than that in NV[(12.6±1.6),(12.2±2.3) vs (10.7±2.1) m/s respectively both P<0.01]. The albumin in the SVO and IVO were both significantly lower than the NV patients [(36.9±4.0) vs (38.6±4.0) and (39.6±6.5)g/L, respectively both P<0.05].No significant changes were observed in PWV for the NV and IVO patients, however in the SVO patients PWV was increased associated with lower albumin, elevated SBP and hs-CRP.Conclusion Our date study demonstrates that continuous volume overload is strongly associated with increased large arterial stiffness in CAPD patients, which might be related to blood pressure,or nutritional status.