Abstract
Decreased skeletal muscle has been identified as a relevant factor for arterial stiffness but has not been thoroughly investigated in peritoneal dialysis (PD) patients. The aim of this study was to investigate the relationship between skeletal muscle and arterial stiffness in PD patients. A cross-sectional study of 658 prevalent PD patients with a mean brachial-ankle pulse wave velocity (baPWV) of 1714 (±501) cm/s and mean skeletal muscle mass of 26.6 (±5.4) kg was performed. Skeletal muscle mass level was significantly higher in males than in females. When examining skeletal muscle mass as a continuous variable, skeletal muscle mass was significantly associated with baPWV in fully adjusted linear regression models in total patients [standardized coefficients (β), −0.181; 95% confidence interval (95% CI), −0.276 to −0.056; P = 0.003] or female patients (β, −0.119; 95% CI, −0.350 to −0.015; P = 0.03) but not in male patients (β, −0.117; 95% CI, −0.300 to 0.011; P = 0.07). Furthermore, in females, a significant association between the middle or highest tertile of skeletal muscle mass and baPWV was found in fully adjusted models (β, −0.123; 95% CI, −0.204 to −0.008; P = 0.03; β, −0.140; 95% CI, −0.228 to −0.016; P = 0.02, respectively). In conclusion, decreased skeletal muscle mass was independently associated with increased baPWV in PD patients, and this association was significant in females but not in males.
Highlights
Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy and is becoming more important in the treatment of patients with end-stage renal disease (ESRD)[1,2]
Previous studies have reported that increased visceral fat and reduced skeletal muscle mass are independently associated with increased brachial-ankle pulse wave velocity, which is an indicator of arterial stiffness in the general population[10], the elderly[11], and type 2 diabetic subjects[12,13]
805 continuous ambulatory peritoneal dialysis (PD) (CAPD) patients underwent a vascular profiler test at our PD center from January 1, 2014, to October 31, 2016, of whom 107 patients were on PD less than 3 months, 5 patients were younger than 18 years, 7 patients were transferred from failed renal transplantation, 15 patients were transferred from permanent hemodialysis, and 13 patients were catheterized in another hospital
Summary
Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy and is becoming more important in the treatment of patients with end-stage renal disease (ESRD)[1,2]. Previous longitudinal epidemiological studies have demonstrated the independent predictive value of arterial stiffness for CVD mortality in dialysis patients[6,7,8]. For this reason, identifying and correcting modifiable factors associated with arterial stiffness will be beneficial to reduce CVD burden in PD patients. Previous studies have reported that increased visceral fat and reduced skeletal muscle mass are independently associated with increased brachial-ankle pulse wave velocity (baPWV), which is an indicator of arterial stiffness in the general population[10], the elderly[11], and type 2 diabetic subjects[12,13]. We hypothesized that there would be a gender-specific association between skeletal muscle mass and baPWV, after which we performed subgroup analyses to assess whether this association differed in male and female PD patients
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