Clinical correlates of arterial stiffness assessed by the cardio-ankle vascular index in peritoneal dialysis patients

Jen-Pi Tsai^a, Yu-Hsien Lai^b, Chih-Hsien Wang^b, Bang-Gee Hsu^{b, c}, Te-Chao Fang^{b, c}

^a Department of Nephrology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^b Department of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^c Department of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan

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Abstract
Objective

The cardio-ankle vascular index (CAVI) is a novel and accurate method, independent of the effect of blood pressure, and is used as a predictor of arterial stiffness (AS). However, the application of CAVI to identify the prevalence and clinical correlates of AS in peritoneal dialysis (PD) patients remains under investigation. The objective of this study was to explore the clinical correlates of PD patients with AS diagnosed by the CAVI examination compared with PD patients without AS.

Materials and Methods

A total of 50 patients who had undergone PD for more than 3 months were enrolled in this cross-sectional study. AS was defined as a CAVI ≥ 9. The clinical correlations between CAVI and AS in PD patients were studied.

Results

These PD patients had a high prevalence (42%) of AS. Age, systolic blood pressure, history of cardiovascular disease, hematocrit, glucose level, and phosphorus level were positively correlated with AS in PD patients compared with those without AS. Furthermore, multivariate regression analysis showed that age [adjusted odds ratio (OR) = 1.116, p = 0.010]; systolic blood pressure (adjusted OR = 1.080, p = 0.010); hematocrit (adjusted OR = 1.896, p = 0.006); and history of cardiovascular disease (adjusted OR = 35.492, p = 0.013) were all independently correlated with AS in PD patients.

Conclusion

The prevalence of AS in PD patients was high. Older age, elevated systolic blood pressure, hematocrit, and history of cardiovascular disease were positively related to the AS process shown by CAVI assessment in PD patients. However, further studies are needed to elucidate these factors, especially the hematocrit, affecting AS in PD patients after long-term follow-up.

Keywords
Arterial stiffness; Cardio-ankle vascular index; Dialysis; Peritoneal dialysis; Systolic blood pressure