The modality of dialysis does not influence atheromatous vascular disease progression or cardiovascular outcomes in dialysis patients without previous cardiovascular disease

There is limited and inconclusive information regarding the influence of the modality of renal replacement therapy on the atherosclerotic burden of patients on dialysis. The aim of this study was to compare the prevalence of asymptomatic atheromatous carotid disease, as also its rate of progression...

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Bibliographic Details
Published in:PloS one 2017-11, Vol.12 (11), p.e0186921-e0186921
Main Authors: Borràs Sans, Mercè, Pérez-Fontán, Miguel, Martinez-Alonso, Montserrat, Bajo, Auxiliadora, Betriu, Àngels, Valdivielso, José M, Fernández, Elvira
Format: Article
Language:English
Subjects:
Adult
Ankle
Arteriosclerosis
Atherosclerosis
Atherosclerosis - pathology
Biology and Life Sciences
Calcification
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - pathology
Care and treatment
Carotid arteries
Carotid Arteries - diagnostic imaging
Diabetes
Diabetes mellitus
Diagnosis
Dialysis
Dialysis equipment (Medical treatment)
Disease control
Disease Progression
Family medical history
Female
Health risks
Hemodialysis
Humans
Kidney transplantation
Kidneys
Male
Medicine and Health Sciences
Middle Aged
Mortality
Nephrology
Patients
Peritoneal dialysis
Peritoneum
Physical Sciences
Plaques
Prospective Studies
Renal Dialysis - methods
Renal replacement therapy
Risk assessment
Studies
Survival Analysis
Ultrasound
Uric acid
Vascular diseases
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Summary:There is limited and inconclusive information regarding the influence of the modality of renal replacement therapy on the atherosclerotic burden of patients on dialysis. The aim of this study was to compare the prevalence of asymptomatic atheromatous carotid disease, as also its rate of progression and cardiovascular outcomes, in two matched populations of patients treated with hemodialysis (HD) and peritoneal dialysis (PD). Following a prospective, observational and multicenter design, we compared 237 PD and 237 HD patients without previous cardiovascular disease, included in the NEFRONA study, and matched for age, sex, diabetes and time on dialysis. Carotid ultrasound study was performed at baseline and after two years of follow-up in 6 carotid territories. Atheromatous vascular disease (AVD) progression was defined as any increase in the number of territories with plaques after 2 years. Fatal and non fatal cardiovascular events were also recorded during 36-month of follow-up. At baseline, PD patients presented a worse general cardiovascular risk profile than HD patients. On the contrary, some markers of prevalent atherosclerotic disease (common carotid intima-media thickness and ankle-brachial index) were more favorable in PD patients. During follow-up, we observed no differences either in the rate of progression of atheromatous vascular disease (OR 1.78, 95% CI 0.80-4.06, p = 0.161) or in the incidence of cardiovascular events (OR 1.51, 95% CI 0.85-2.66, p = 0.159), according to the modality of dialysis. Dialysis modality did not impact on atherosclerotic carotid disease progression or cardiovascular outcomes, in two groups of patients treated with PD or HD.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0186921