The Effect Of The Peritoneal Transport Function On The Progression Of Carotid Artery Calcification And Cardiovascular Event In Patients With Continuous Ambulatory Peritoneal Dialysis

Objective Investigating the relationship between the peritoneal transport function and cardiovascular artery calcification in patients with continuous ambulatory peritoneal dialysis(CAPD)and its effect on cardiovascular events.Method 60 chosen long-term follow-up CAPD patients were selected and divided into high transport group(D/P>0.65)and low transport group(D/P?0.65)according to the standard of peritoneal equilibrium test(PET).For the two groups of patients,we measured their albumin(ALB),blood fat including total cholesterol(TC),triglyceride(TG),highdensity lipoprotein(HDL),low-density lipoprotein(LDL),high sensitive C reactive protein(hs-CRP),parathyroid hormone(PTH)and other biochemical indicators,and carried on carotid duplex ultrasound to measure carotid intima-media thickness(c IMT).With a longterm follow-up of 12 months,we collected new occurrences of cardiovascular events,observed the differences of the above-mentioned biochemical indicators,c IMT and cardiovascular events between different groups of patients with different peritoneal transport functions,and analyzed the influencing factors of the carotid artery calcification progression and the cardiovascular events of CAPD patients.Results(1)The ALB level of the patients in the high transport group was significantly lower than that of the low transport group(P<0.05),and the hs-CRP level was significantly higher than that of the low transport group(P<0.001),and other biochemical indicators have no statistical significance.(2)The c-IMT thickening in patients with high transport group was obvious(P<0.01),and their new occurrences of cardiovascular events was also significantly higher than that in the patients with low transport group(P<0.01).(3)Pearson correlation analysis showed that D/P value was positively correlated with hs-CRP(r=0.606,P<0.001),and negatively correlated with ALB(r=-0.364,P<0.005).(4)The Logistic regression analysis showed that the increase of hs-CRP(OR=6.894,95%CI 2.204 ~ 21.559,P=0.001)and the increase of D/P(OR=1.927,95%CI 1.072 ~ 3.464,P=0.002)are risk factors for the progression of carotid artery calcification.(5)During the 12 months of follow-up,Logistic regression analysis showed that c IMT thickening was an independent risk factor for cardiovascular events(OR=5.430,95%CI 3.895~12.954,P=0.001).Conclusion Patients with high peritoneal transport are more likely to develop a wide range of micro-inflammatory state,and the micro-inflammatory state and the characteristic of high peritoneal transport are the risk factors for the progression of carotid arterycalcification in patients with CAPD.Compared with patients with low peritoneal transport,the risk of cardiovascular events in patients with high peritoneal transport is higher.