Korean J Nephrol.  2002 Mar;21(2):285-294.

Relationship between Inflammatory Markers and High Resolution B-mode Carotid Artery Ultrasonography in Continuous Ambulatory Peritoneal Dialysis(CAPD) Patients

• Song HY
• Song YS
• Ahn CW
• Kang SW
• Choi KH
• Ha SK
• Lee HC
• Lee HY
• Han DS

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.

Keyword

Continuous ambulatory peritoneal dialysis; Albumin; C-reactive protein; Carotid artery intima-media thickness; atherosclerosis

MeSH Terms

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*
C-Reactive Protein
Serum Albumin