BACKGROUND:Pulse wave velocity is a measurement of arterial stiffness and associated with increased cardiovascular mortality. Previous reports in peritoneal dialysis have linked increased pulse wave velocity with an expansion in extracellular water. As cardiovascular mortality is increased in peritoneal dialysis patient, we wished to determine whether changes in pulse wave velocity mirrored changes in extracellular water.
METHODS:We repeated aortic pulse wave velocity and bioimpedance-derived extracellular water measurements in peritoneal dialysis patients attending for assessment of peritoneal membrane function.
RESULTS:Sixty-six patients, 41 males (62.1%), mean age of 66.2 ± 13.9 years, median duration of peritoneal dialysis treatment (14.3 (3.1-31.9) months) had repeated measurement 6.4 (5.8-10.2) months apart, with no significant change in aortic pulse wave velocity (10.1 ± 3.2 to 9.9 ± 2.8 m/s). In univariate analysis, the initial aortic pulse wave velocity was associated with extracellular water (r = 0.26, p = 0.034) and serum N-terminal pro brain-type natriuretic peptide (r = 0.25, p = 0.04), and on follow-up, aortic pulse wave velocity with N-terminal pro brain-type natriuretic peptide (r = 0.31, p = 0.01). Aortic pulse wave velocity increased in 50% of patients, and these patients had greater serum C-reactive protein 3(2-10) versus 2(1-4) mg/L, and ferritin (778(444-1099) versus 585(313-811), p < 0.05), but there were no differences in either absolute or adjusted extracellular water. Both log C-reactive protein (odds ratio 4.7 (95% confidence limits 1.3-17.1), p = 0.019) and prescription of calcium channel blockers (odds ratio 4.9 (95% confidence limits 1.2-19.1), p = 0.024) were independently associated with an increase in aortic pulse wave velocity.
CONCLUSION:We did not find an independent association between a change in aortic pulse wave velocity and extracellular water, suggesting that changes in aortic stiffness in peritoneal dialysis patients are more complex than simply following changes in extracellular water.
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【Changes in aortic pulse wave velocity in peritoneal dialysis do not mirror changes in extracellular water measured by bioimpedance.].
【腹膜透析中主动脉脉搏波速度的变化不能反映出通过生物阻抗测量的细胞外水的变化。】
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DOI：10.1177/0391398820931109文章类型：杂志文章
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背景：脉搏波速度是对动脉僵硬度的一种测量，并与心血管死亡率的增加有关。腹膜透析的先前报道已将脉搏波速度增加与细胞外水的膨胀联系起来。随着腹膜透析患者心血管疾病死亡率的增加，我们希望确定脉搏波速度的变化是否反映了细胞外水的变化。
方法：我们对参加腹膜透析功能评估的腹膜透析患者重复进行主动脉脉搏波速度和生物阻抗来源的细胞外水测量。
结果：66例患者，男性41例（62.1％），平均年龄为66.2±13.9岁，腹膜透析治疗的中位时间为14.3（3.1-31.9）个月，重复测量间隔为6.4（5.8-10.2）个月，主动脉脉搏波速度无明显变化（10.1±3.2±9.9±2.8μm/ s）。在单变量分析中，初始主动脉脉搏波速度与细胞外水（r = 0.26，p = 0.034）和血清N端脑前利尿钠肽（r = 0.25，p = 0.04）有关，并随诊N端脑部利钠肽前体的主动脉脉搏波速度（r = 0.31，p = 0.01）。 50％的患者主动脉脉搏波速度增加，这些患者的血清C反应蛋白3（2-10）比2（1-4）mg / L和铁蛋白（778（444-1099）对585（ 313-811），p <0.05），但绝对或调整后的细胞外水均无差异。 log C反应蛋白（比值4.7（95％置信度极限1.3-17.1），p = 0.019）和钙通道阻滞剂的处方（ods比4.9（95％置信度1.2-19.1），p = 0.024）是独立的与主动脉脉搏波速度增加有关。
结论：我们没有发现主动脉脉搏波速度变化与细胞外水之间存在独立的联系，这表明腹膜透析患者的主动脉僵硬度变化比单纯跟随细胞外水变化更为复杂。
方法：我们对参加腹膜透析功能评估的腹膜透析患者重复进行主动脉脉搏波速度和生物阻抗来源的细胞外水测量。
结果：66例患者，男性41例（62.1％），平均年龄为66.2±13.9岁，腹膜透析治疗的中位时间为14.3（3.1-31.9）个月，重复测量间隔为6.4（5.8-10.2）个月，主动脉脉搏波速度无明显变化（10.1±3.2±9.9±2.8μm/ s）。在单变量分析中，初始主动脉脉搏波速度与细胞外水（r = 0.26，p = 0.034）和血清N端脑前利尿钠肽（r = 0.25，p = 0.04）有关，并随诊N端脑部利钠肽前体的主动脉脉搏波速度（r = 0.31，p = 0.01）。 50％的患者主动脉脉搏波速度增加，这些患者的血清C反应蛋白3（2-10）比2（1-4）mg / L和铁蛋白（778（444-1099）对585（ 313-811），p <0.05），但绝对或调整后的细胞外水均无差异。 log C反应蛋白（比值4.7（95％置信度极限1.3-17.1），p = 0.019）和钙通道阻滞剂的处方（ods比4.9（95％置信度1.2-19.1），p = 0.024）是独立的与主动脉脉搏波速度增加有关。
结论：我们没有发现主动脉脉搏波速度变化与细胞外水之间存在独立的联系，这表明腹膜透析患者的主动脉僵硬度变化比单纯跟随细胞外水变化更为复杂。
