Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, Zhejiang, PR China.
Ren Fail. 2012;34(10):1206-11. doi: 10.3109/0886022X.2012.718954. Epub 2012 Sep 25.
Atherosclerosis is the most common cause of cardiovascular morbidity in end-stage renal disease (ESRD) patients and carotid intima-media thickness (IMT) is an early independent predictor of atherosclerosis. The aim of this study is to compare the continuous ambulatory peritoneal dialysis (CAPD) and the maintenance hemodialysis (MHD) for carotid IMT in Chinese ESRD patients. A total of 72 CAPD patients, 92 MHD patients, and 50 age- and sex-matched healthy controls were included. Dialysis patients were divided into five subgroups according to dialysis duration: 3-6, 7-12, 13-59, 60-119, and 120-179 months. Carotid IMT and carotid plaques were detected for each patient. The carotid IMT and total plaque detection rate in the CAPD and MHD groups were considerably higher than in the healthy control group (p < 0.01). No significant difference was found in the carotid IMT and total plaque detection rate between the CAPD group and the MHD group (p > 0.05). However, after stratification by dialysis duration, the total carotid IMT in the CAPD subgroup was higher than in the MHD subgroup in dialysis duration of 60-119 and 120-179 months (p < 0.05), and there was no significant difference in the total plaque detection rate between the CAPD and MHD subgroups in the same dialysis duration (p > 0.05). Our study showed that both CAPD and MHD affect carotid IMT in Chinese ESRD patients, and the degree of atherosclerosis in CAPD patients might be higher than that in MHD patients after 5 years of dialysis.
动脉粥样硬化是终末期肾病(ESRD)患者心血管发病率最高的原因,颈动脉内膜中层厚度(IMT)是动脉粥样硬化的早期独立预测因子。本研究旨在比较中国 ESRD 患者中持续不卧床腹膜透析(CAPD)和维持性血液透析(MHD)对颈动脉 IMT 的影响。共纳入 72 例 CAPD 患者、92 例 MHD 患者和 50 名年龄和性别匹配的健康对照者。根据透析时间将透析患者分为五组:3-6、7-12、13-59、60-119 和 120-179 个月。为每位患者检测颈动脉 IMT 和颈动脉斑块。CAPD 和 MHD 组的颈动脉 IMT 和总斑块检出率明显高于健康对照组(p<0.01)。CAPD 组和 MHD 组之间颈动脉 IMT 和总斑块检出率无显著差异(p>0.05)。然而,按透析时间分层后,在 60-119 个月和 120-179 个月的透析时间内,CAPD 亚组的总颈动脉 IMT 高于 MHD 亚组(p<0.05),而在相同透析时间内,CAPD 和 MHD 亚组的总斑块检出率无显著差异(p>0.05)。我们的研究表明,CAPD 和 MHD 均影响中国 ESRD 患者的颈动脉 IMT,透析 5 年后 CAPD 患者的动脉粥样硬化程度可能高于 MHD 患者。