Association between Dyslipidemia and Peritoneal Dialysis Technique Survival
DOI:
https://doi.org/10.3889/oamjms.2019.664Keywords:
Peritoneal dialysis, Atherogenic dyslipidemia, Technique failure, Technique survival, PD adequacyAbstract
BACKGROUND: A large body of research has investigated the effects of pro-atherogenic lipid profile on cardiovascular diseases (CVD) in peritoneal dialysis (PD) patients. However, there is a general lack of research on the association between atherogenic dyslipidemia and PD technique survival.
AIM: The study aimed to define the association between dyslipidemia and PD technique survival.
METHODS: It was a prospective single-centre observational study involving 40 outpatients on continuous ambulatory PD treatment for more than 3 months between 2010 and 2016 in a single centre in Ukraine. There were 27 males and 13 females. The mean age of the participants was 49.3 ± 12.2 years. The primary outcome measures were all-cause technique failure.
RESULTS: Atherogenic dyslipidemia was identified in 28/40 (70 %) patients and correlated with PD adequacy parameters. During the 36-month- follow-up period technique failure occurred in 2/12 (16.6 %) patients with atherogenic dyslipidemia compared with 12 / 28 (42.9 %) patients without atherogenic dyslipidemia (c2 = 2.5; p = 0.12). In the univariate Cox regression model, atherogenic dyslipidemia at baseline was significantly associated with a higher risk of all-cause PD technique failure (HR 4.5; 95% CI 1.6 to 12.9; c2 = 5.5, p = 0.019).
CONCLUSION: The presence of atherogenic dyslipidemia was significantly associated with a higher risk of technique failure in PD patients. This is an important issue for future research. Further well-designed clinical trials are needed to determine the impact of dyslipidemia on PD adequacy and technique survival.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Barone R, Cámpora M, Gimenez N, Ramirez L, Panese S, Santopietro M. Peritoneal Dialysis as a first versus second option after previous haemodialysis: a very long-term assessment. Int J Nephrol. 2014; 2014:693670. https://doi.org/10.1155/2014/693670 PMid:25505992 PMCid:PMC4258321
Jain AK, Blake P, Cordy P, Garg AX. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol. 2012; 23(3):533-44. https://doi.org/10.1681/ASN.2011060607 PMid:22302194 PMCid:PMC3294313
Kolesnyk I, Noordzij M, Kolesnyk M, Kulyzky M, Jager K. Renal replacement therapy in Ukraine: epidemiology and international comparisons. Clin Kidney J. 2014; 7(3):330-5. https://doi.org/10.1093/ckj/sfu037 PMid:25852905 PMCid:PMC4377756
Velloso MS, Otoni A, de Paula Sabino A, de Castro WV, Pinto SW, Marinho MA, et al. Peritoneal dialysis and inflammation. Clin Chim Acta. 2014; 430:109-14. https://doi.org/10.1016/j.cca.2013.12.003 PMid:24333488
Cho Y, Hawley CM, Johnson DW. Clinical causes of inflammation in peritoneal dialysis patients. Int J Nephrol. 2014; 2014:909373. https://doi.org/10.1155/2014/909373 PMid:24895536 PMCid:PMC4033334
Baroni G, Schuinski A, de Moraes T, Meyer F, Pecoits-Filho R. Inflammation and the peritoneal membrane: causes and impact on structure and function during peritoneal dialysis. Mediators Inflamm. 2012; 2012:912595. https://doi.org/10.1155/2012/912595 PMid:22547910 PMCid:PMC3323921
Termorshuizen F, Korevaar JC, Dekker FW, Van Manen JG, Boeschoten EW, et al. Hemodialysis and peritoneal dialysis: comparison of adjusted mortality rates according to the duration of dialysis: analysis of The Netherlands Cooperative Study on the Adequacy of Dialysis 2. J Am Soc Nephrol. 2003; 14(11):2851-60. https://doi.org/10.1097/01.ASN.0000091585.45723.9E PMid:14569095
Jaar BG, Coresh J, Plantinga LC, Fink NE, Klag MJ, et al. Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease. Ann Intern Med. 2005;143(3):174-83. https://doi.org/10.7326/0003-4819-143-3-200508020-00003 PMid:16061915
Wu C-L, Wu H-M, Chiu P-F, Liou HH, Chang CB, Tarng DC, et al. Associations between the duration of dialysis, endotoxemia, monocyte chemoattractant protein-1, and the effects of a short-dwell exchange in patients requiring continuous ambulatory peritoneal dialysis. Stover CM, ed. PLoS One. 2014; 9(10):e109558. https://doi.org/10.1371/journal.pone.0109558 PMid:25286027 PMCid:PMC4186838
Tonelli MA, Wanner C. Kidney disease: improving global outcomes (KDIGO) lipid work group. KDIGO clinical practice guideline for lipid management in chronic kidney disease. Kidney International Supplements. 2013; 3(3):1-315.
Chiu YW, Mehrotra R. Can we reduce the cardiovascular risk in peritoneal dialysis patients? Indian J Nephrol. 2010; 20(2):59-67. https://doi.org/10.4103/0971-4065.65296 PMid:20835317 PMCid:PMC2931134
Mikolasevic I, Žutelija M, Mavrinac V, Orlic L. Dyslipidemia in patients with chronic kidney disease: etiology and management. Int J Nephrol Renovasc Dis. 2017; 10:35-45. https://doi.org/10.2147/IJNRD.S101808 PMid:28223836 PMCid:PMC5304971
Omran J, Al-Dadah A, Dellsperger KC. Dyslipidemia in patients with chronic and end-stage kidney disease. Cardiorenal Med. 2013; 3(3):165-77. https://doi.org/10.1159/000351985 PMid:24454313 PMCid:PMC3884190
Yang W-L, Zhu X-Y, Zhu N, Chun-Yan Su, Qing-Feng Han, Tao Wang, et al. What's the optimal lipids level for dialysis patients? A cohort study from a Chinese dialysis center in a university hospital. PLoS One. 2016; 11(12):e0167258. https://doi.org/10.1371/journal.pone.0167258 PMid:27992532 PMCid:PMC5161355
Shurraw S, Tonelli M. Statins for treatment of dyslipidemia in chronic kidney disease. Perit Dial Int. 2006; 26:523-39.
Rincón Bello A, Bucalo L, Abad Estébanez S, Barraca Núñez D, Yuste Lozano C, Pérez de José A, et al. Fat tissue and inflammation in patients undergoing peritoneal dialysis. Clinical Kidney Journal. 2016; 9(3):374-80. https://doi.org/10.1093/ckj/sfw007 PMid:27274820 PMCid:PMC4886903
de Mattos AM, Ovidio PP, Jordão AA, da Costa JA, Chiarello PG. Association of body fat with inflammation in peritoneal dialysis. Inflammation. 2013; 36(3):689-95. https://doi.org/10.1007/s10753-013-9593-3 PMid:23321723
Fernström A, Hylander B, Moritz A, Jacobsson H, Rössner S. Increase of intra-abdominal fat in patients treated with continuous ambulatory peritoneal dialysis. Perit Dial Int. 1998; 18(2):166-71.
Harmankaya O, Akalin N, Akay H, Okuturlar Y, Erturk K, Kaptanogullari H, et al. Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients. Clinics. 2015; 70(9):601-605. https://doi.org/10.6061/clinics/2015(09)01
Chen H-Y, Tsai W-C, Chiu Y-L, Hsu SP, Pai MF, Yang JY, et al. Triglyceride to high-density lipoprotein cholesterol ratio predicts cardiovascular outcomes in prevalent dialysis patients. Medicine. 2015; 94(10):e619. https://doi.org/10.1097/MD.0000000000000619 PMid:25761189 PMCid:PMC4602469
Ronco C. Adequacy of peritoneal dialysis is more than Kt/V. Nephrol Dial Transplant. 1997; 12(1):68-73.
Heimburger O. How should we measure peritoneal dialysis adequacy in the clinic. Contrib Nephrol. 2009; 163:140-6. https://doi.org/10.1159/000223792 PMid:19494607
Liao CT, Kao TW, Chou YH, Wu MS, Chen YM, Chuang HF, et al. Associations of metabolic syndrome and its components with cardiovascular outcomes among non-diabetic patients undergoing maintenance peritoneal dialysis. Nephrol Dial Transplant. 2011; 26(12):4047-54. https://doi.org/10.1093/ndt/gfr175 PMid:21565947
Habib AN, Baird BC, Leypoldt JK, Cheung AK, Goldfarb-Rumyantzev AS. The association of lipid levels with mortality in patients on chronic peritoneal dialysis, Nephrol Dial Transplant, 2006; 21(10):2881-92. https://doi.org/10.1093/ndt/gfl272 PMid:16735386
Lin YC, Lin YC, Peng CC, Chen KC, Chen HH, Fang TC, et al. Effects of cholesterol levels on mortality in patients with long-term peritoneal dialysis based on residual renal function. Nutrients. 2018; 10(3):300. https://doi.org/10.3390/nu10030300 PMid:29510483 PMCid:PMC5872718
Cho Y, Büchel J, Steppan S, et al. Longitudinal trend in lipid profile of incident peritoneal dialysis patients is not influenced by the use of biocompatible solutions. Perit Dial Int. 2016; 36(2):146-153. https://doi.org/10.3747/pdi.2014.00291 PMid:26429421 PMCid:PMC4803359
Liu X, Dai C. Advances in understanding and management of residual renal function in patients with chronic kidney disease. Kidney Dis. 2017; 2(4):187-196. https://doi.org/10.1159/000449029 PMid:28232935 PMCid:PMC5260570
Rincón Bello A, Bucalo L, Abad Estébanez S, Vega MartÃnez A, Barraca Núñez D, Yuste Lozano C, et al. Fat tissue and inflammation in patients undergoing peritoneal dialysis. Clin Kidney J. 2016; 9(3):374-380. https://doi.org/10.1093/ckj/sfw007 PMid:27274820 PMCid:PMC4886903
Guo Q, Lin J, Li J, Yi C, Mao H, Yang X, et al. The effect of fluid overload on clinical outcome in southern chinese patients undergoing continuous ambulatory peritoneal dialysis. Perit Dial Int. 2015; 35(7):691-702. https://doi.org/10.3747/pdi.2014.00008 PMid:26152580 PMCid:PMC4690624
Lin YC, Lin YC, Peng CC, et al. Effects of Cholesterol Levels on Mortality in Patients with Long-Term Peritoneal Dialysis Based on Residual Renal Function. Nutrients. 2018; 10(3):300. https://doi.org/10.3390/nu10030300 PMid:29510483 PMCid:PMC5872718
Tsimihodimos V, Mitrogianni Z, Elisaf M. Dyslipidemia associated with chronic kidney disease. Open Cardiovasc Med J. 2011; 5:41-48. https://doi.org/10.2174/1874192401105010041 PMid:21643500 PMCid:PMC3106357
Holmes CJ. Reducing cardiometabolic risk in peritoneal dialysis patients: role of the dialysis solution. J Diabetes Sci Technol. 2009; 3(6):1472-1480. https://doi.org/10.1177/193229680900300629 PMid:20144403 PMCid:PMC2787049
Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The current state of peritoneal dialysis. . J Am Soc Nephrol. 2016; 27(11):3238-3252. https://doi.org/10.1681/ASN.2016010112 PMid:27339663 PMCid:PMC5084899
Liu Y, Coresh J, Eustace JA, Longenecker JC, Jaar B, Fink NE, Tracy RP, Powe NR, Klag MJ. Association between cholesterol level and mortality in dialysis patients: role of inflammation and malnutrition. Jama. 2004; 291(4):451-9. https://doi.org/10.1001/jama.291.4.451 PMid:14747502
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Natalia Stepanova, Olena Burdeyna (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0