Association between arterial stiffness and peritoneal fluid kinetics

Am J Nephrol. 2008;28(1):128-32. doi: 10.1159/000109981. Epub 2007 Oct 17.


Background: A high peritoneal transport status in continuous ambulatory peritoneal dialysis (CAPD) patients is associated with a markedly increased morbidity and mortality. While the causes are as yet unknown, overall the proportion of deaths due to cardiovascular disease is estimated at 40-50% among dialysis patients. Arterial stiffness has been established as a cardiovascular risk factor, while the links between peritoneal transport status and aortic stiffness have not yet been investigated.

Methods: We included 65 prevalent CAPD patients (24 males/41 females) from our center in a cross-sectional study. Arterial stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral pulse wave velocity (C-F PWV). The patients' peritoneal fluid transport was assessed by kinetic modeling. The patients' peritoneal small solute transport rate was assessed by D/P(cr) at 4 h. Extracellular water to total body water (E/T) ratio was assessed by means of bioimpedance analysis. C-reactive protein was also measured.

Results: C-F PWV was positively correlated with patients' age (r = 0.489, p < 0.01), diabetic status (r = 0.327, p < 0.01), peritoneal fluid absorption rate (Ke; r = 0.251, p < 0.05), PP (r = 0.483, p < 0.01), and E/T (r = 0.517, p < 0.01). Multivariate regression analysis showed that C-F PWV was independently related to E/T (p < 0.01), PP (p < 0.01), age (p < 0.05), and Ke (p < 0.05).

Conclusion: Peritoneal fluid transport (Ke), as well as E/T, age and PP were found to be independent predictors of elevated C-F PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased Ke rate, hypothetically through generalized vasculopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Diseases / epidemiology*
  • Aortic Diseases / physiopathology*
  • Ascitic Fluid / metabolism
  • Cross-Sectional Studies
  • Dialysis Solutions / pharmacokinetics
  • Electric Impedance
  • Female
  • Humans
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy
  • Kinetics
  • Male
  • Middle Aged
  • Models, Biological
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Prevalence
  • Pulsatile Flow
  • Risk Factors


  • Dialysis Solutions