Abstract

Aims: This study aims to access the predicting value of serum uric acid (UA) and high-sensitivity C reactive protein (hs-CRP) concentration on three-year cardiovascular-related mortality in patients performing continuous ambulatory peritoneal dialysis (CAPD).Methods: A total of267 CAPD patients [150 male (56.2%); mean age 48.93 ± 13.58 years] were included in our study. All patients had measured serum UA and hs-CRP concentration. A high-sensitivity particle-enhanced immunoturbidimetric assay determined serum hs-CRP; serum UA levels were determined using an enzymatic colorimetric assay. All patients were followed for three years to detect cardiovascular-related mortality by cardiologists and stroke specialists.Results: Mean serum UA level was 415.16 ± 84.28 µmol/L, 58.4% of patients had increased serum UA level. Median serum hs-CRP level was 2 (1-4) mg/L, 12.4% of patients had increased serum hs-CRP level. During 36 months of follow-up, 41 patients (15.4%) had cardiovascular-related mortality. The results of Cox proportional hazards regression showed that hypertension, diabetes, high serum UA and hs-CRP were risk factors that related to cardiovascular-related mortality (p<0.05). The receiver operating characteristic (ROC) curve and Kaplan-Meier analysis results showed that UA and hs-CRP level had predictive value for three-year cardiovascular-related mortality in CAPD patients [uric acid: area under the curve (AUC)=0.822; hs-CRP: AUC=0.834, p < 0.001].Conclusion: High serum UA and hs-CRP levels were predictive factors of cardiovascular-related mortality in CAPD patients.

Highlights

  • Peritoneal dialysis (PD) is one of the most common kidney replacement therapies

  • The results of Cox proportional hazards regression showed that hypertension, diabetes, high serum uric acid (UA) and high-sensitivity C reactive protein (hs-C-reactive protein (CRP)) were risk factors that related to cardiovascular-related mortality (p

  • The receiver operating characteristic (ROC) curve and Kaplan-Meier analysis results showed that UA and hs-CRP level had predictive value for threeyear cardiovascular-related mortality in continuous ambulatory peritoneal dialysis (CAPD) patients [uric acid: area under the curve (AUC)=0.822; hsCRP: AUC=0.834, p < 0.001]

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Summary

Introduction

Peritoneal dialysis (PD) is one of the most common kidney replacement therapies. Peritoneal dialysis is performed by using a catheter to infuse sterile solution into the peritoneal cavity. The peritoneum is used as an exchange filter to remove solutes [1,2,3]. PD consists of two methods: continuous ambulatory and automated PD, in which continuous ambulatory PD (CAPD) is widely used in Vietnam. A mortality rate in CAPD from 8.3% to 39.2% was reported in previous studies [4,5,6]. Prolonged use of CAPD is related to a higher mortality rate [4,6], in which mortality due to cardiovascular events was behind infection-related ones

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