Zamiah S A K Sharifah, Draman Che Rosle, Seman Mohd Ramli, Safhan A Fariz, Rozalina R, Nik Ruzni N I
Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University of Malaysia, Pahang, Malaysia.
Department of Internal Medicine, Kulliyyah of Medicine, International Islamic University of Malaysia, Pahang, Malaysia.
Saudi J Kidney Dis Transpl. 2018 Jan-Feb;29(1):114-119. doi: 10.4103/1319-2442.225185.
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital. Both the traditional and non-traditional CV risk factors were recorded and compared between the two groups. Eighty-eight patients were recruited. Forty-five were treated with CAPD and 43 patients were treated with IHD. The mean age was 49.5 ± 15.17 years old and 54.5% were females. Eighty percent were Malay followed by Chinese (14.7%) and Indian (5.7%). Thirty-eight percent were hypertensive and 17% were diabetic. The mean age of CAPD patients was 48.9 ± 16.9 compared to 50 ± 13.5 years old for IHD patients (P > 0.05). The body mass index (BMI) of CAPD patients was 23.9 kg/m versus 21.7 kg/m of the IHD (P = 0.04). The systolic and diastolic blood pressure of CAPD patients were 158 and 89 mm Hg in comparison to 141 and 72 mm Hg in IHD patients (P <0.001) and their total and low-density lipoprotein cholesterol level were 5.93 mmol/L and 3.84 mmol/L versus 4.79 mmol/L and 2.52 mmol/L, respectively (P≤0.001). The CAPD patients were hyperglycemic more than IHD patients, although it was not statistically significant. All the nontraditional CV risk factors except serum albumin were comparable between the two groups. Serum albumin in CAPD patients was 35.5 g/L compared to 40.8 g/L in the IHD patients (P <0.001). In our prevalent dialysis-dependent patients, both traditional and non-traditional CV risk factors are common. Due to the prolonged and continuous glucose exposure from the peritoneal dialysis fluid, the CAPD patients had highly atherogenic serum, higher BMI, and intensified inflammation which pre-disposed them to higher CV events.
心血管(CV)事件是透析患者最常见的死亡原因。在这一人群中,与营养不良、炎症和贫血相关的传统及非传统CV危险因素普遍存在。本研究旨在评估我院定期透析患者CV危险因素的负担因素及其管理情况。这是一项对我院随访的维持性间歇性血液透析(IHD)和持续性非卧床腹膜透析(CAPD)患者进行的单中心横断面分析。记录并比较两组患者的传统和非传统CV危险因素。共招募了88例患者。45例接受CAPD治疗,43例接受IHD治疗。平均年龄为49.5±15.17岁,女性占54.5%。80%为马来人,其次是华人(14.7%)和印度人(5.7%)。38%为高血压患者,17%为糖尿病患者。CAPD患者的平均年龄为48.9±16.9岁,IHD患者为50±13.5岁(P>0.05)。CAPD患者的体重指数(BMI)为23.9kg/m²,而IHD患者为21.7kg/m²(P=0.04)。CAPD患者的收缩压和舒张压分别为158和89mmHg,而IHD患者为141和72mmHg(P<0.001),其总胆固醇和低密度脂蛋白胆固醇水平分别为5.93mmol/L和3.84mmol/L,而IHD患者分别为4.79mmol/L和2.52mmol/L(P≤0.001)。CAPD患者的血糖水平高于IHD患者,尽管差异无统计学意义。除血清白蛋白外,两组患者的所有非传统CV危险因素均具有可比性。CAPD患者的血清白蛋白为35.5g/L,而IHD患者为40.8g/L(P<0.001)。在我们依赖透析的维持性患者中,传统和非传统CV危险因素均很常见。由于腹膜透析液长时间持续暴露于葡萄糖,CAPD患者的血清具有高度致动脉粥样硬化性、BMI更高且炎症加剧,这使他们更容易发生CV事件。