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Reduced residual renal function is associated with endothelial dysfunction in patients receiving peritoneal dialysis

Authors
 Seung Hyeok Han  ;  Sang Choel Lee  ;  Ea Wha Kang  ;  Jung Kyung Park  ;  Hyang Sook Yoon  ;  Tae-Hyun Yoo  ;  Kyu Hun Choi  ;  Dae-Suk Han  ;  Shin-Wook Kang 
Citation
 PERITONEAL DIALYSIS INTERNATIONAL, Vol.32(2) : 149-158, 2012 
Journal Title
PERITONEAL DIALYSIS INTERNATIONAL
ISSN
 0896-8608 
Issue Date
2012
MeSH
Adult ; Endothelium, Vascular/physiopathology* ; Female ; Humans ; Kidney/physiopathology* ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy* ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory* ; Vascular Diseases/complications ; Vascular Diseases/physiopathology*
Keywords
Endothelial dysfunction ; residual renal function
Abstract
BACKGROUND: Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD).

METHODS: This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia.

RESULTS: In patients with FMD% above the median value (FMD > 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m(2), P = 0.026]. Correlation analyses revealed that residual GFR (ρ = 0.381, P = 0.001) and total Kt/V urea (γ = 0.408, P < 0.001) were positively correlated with FMD%, whereas PD duration (γ = -0.351, P = 0.003), high-sensitivity C-reactive protein (ρ = -0.345, P = 0.003), pulse pressure (γ = -0.341, P = 0.003), and age (γ = -0.403, P < 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% (β = 0.317, P = 0.017).

CONCLUSION: This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.
Files in This Item:
T201200539.pdf Download
DOI
10.3747/pdi.2010.00111
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Jeong Kyung(박정경)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Dae Suk(한대석)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91659
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