Abstract
Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.
Highlights
Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease
80% to 90% of CKD patients demonstrate the presence of vascular calcifications, which is a predictive factor of cardiovascular mortality [3]
This study aims to evaluate the association between presence of vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients
Summary
Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease. Patients with CKD have a 20-fold risk for cardiac-associated deaths [1]. In Mexico, cardiovascular-disease-associated deaths account for 51.6% of total deaths in peritoneal dialysis CKD patients [2]. 80% to 90% of CKD patients demonstrate the presence of vascular calcifications, which is a predictive factor of cardiovascular mortality [3]. Several risk factors for vascular calcification have been described. They are classified as traditional and non-traditional. The traditional factors are diabetes, dyslipidemia, age, genetics, and smoking. The non-traditional risk factors are inflammation, oxidative stress, advanced glycated products, bone mineral disease, and fibroblast growth factor 23 [4].
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