Oxidative Stress Affects Cardiac Function In Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Objective: To investigate and analyze the effects of the oxidative stress on cardiac structure and function in patients on continuous ambulatory peritoneal dialysis(CAPD).Methods: 73 stage 5 chronic kidney disease(CKD5)patients,25 gender and age matched healthy controls were involved in this cross-sectional cohort srudy.Clinical data and biochemical parameters were collected. The analytical method for xanthine oxidase was used to measure the serum superoxide dismutase(SOD),spectrophotometry was used to measure the serum malonyldialdehyde(MDA).The immune turbidimetry was used to measure the serum levels of C-reactive protein(CRP).Serum brain natriuretic peptide(BNP) was measured by enzyme-linked immunosorbent assay(ELISA). The levels of albumin (ALB), total cholesterol(TC), triglyeride (TG),haematoglobin (Hb) and so on were measured meanwhile. Urine and peritoneal dialysate of patients with dialysis were collected and serum urea nitrogen(BUN), creatinine (SCr) and glucose(Glu) were measured to calculate residual renal function (RRF) and urea kinetics (KT/V) per week of patients. The 1eft ventricular end diastolic diameter(LVDd),left atrial diameter(LAD),inter ventricular septal thickness(IVST),left ventricular posterior wall thickness( LVPWT) and left ventricular ejection fraction (LVEF) were measured by ultrasonic cardiography to calculate left ventricular mass index(LVMI),and measured mitral early diastolic and advanced diastolic peak flow ratio(E/A).Result:â‘ Compared with normal control group,the uremia groups had higher serum MDA,CRP levels,but lower SOD levels(P<0.05).The CAPD patients exhibited more serious disturbance of oxidative stress,which change consistent with the degree of severity of cardiac function.â‘¡Cardiac function was poorer,but the level of LVMI, incidence of LVH and diastolic dysfunction (E/A<1) and the level of BNP was higher,and EF% was lower.â‘¢In CAPD patients,BNP was positively correlated with New York Heart Association classification and left ventricular mass index(LVMI),but negatively correlated with LVEF. MDA was positively correlated with LVMI and BNP, but negatively correlated with LVEF.SOD was negatively correlated with LVMI and BNP,but positively correlated with LVEF.Conclusions:â‘ CAPD patients are in the states of oxidative stress.â‘¡CAPD patients Often complicated with cardiac structure and function changes,such as LVH, ST-T ischemic changes, arrhythmia, heart failure.â‘¢Oxidative stress may be associated with cardiac dysfunction in patients with peritoneal dialysis.