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Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis

Cardiovascular disease (CVD) is the leading cause of death in peritoneal dialysis (PD) patients. But the relationship between regular PD and the risk of major adverse cardiovascular events (MACE) remains controversial. The possible risk factors are not fully elucidated. This study aims to investigat...

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Autores principales: Su, Xiaoyan, He, Wanbing, Zhang, Mengbi, Zhang, Yinyin, Zhu, Langjing, Chen, Jie, Huang, Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369253/
https://www.ncbi.nlm.nih.gov/pubmed/35966542
http://dx.doi.org/10.3389/fcvm.2022.920431
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author Su, Xiaoyan
He, Wanbing
Zhang, Mengbi
Zhang, Yinyin
Zhu, Langjing
Chen, Jie
Huang, Hui
author_facet Su, Xiaoyan
He, Wanbing
Zhang, Mengbi
Zhang, Yinyin
Zhu, Langjing
Chen, Jie
Huang, Hui
author_sort Su, Xiaoyan
collection PubMed
description Cardiovascular disease (CVD) is the leading cause of death in peritoneal dialysis (PD) patients. But the relationship between regular PD and the risk of major adverse cardiovascular events (MACE) remains controversial. The possible risk factors are not fully elucidated. This study aims to investigate the possible factors affecting the risk of MACE estimated by high ankle-brachial index (ABI) in PD patients. A total of 243 patients were enrolled and divided into chronic kidney diseases (CKD) stage 1, non-dialyzed CKD stages 2–5, and PD groups. The prevalence of high ABI, indicating increased MACE, was elevated with CKD progression but not further increased in PD patients. Systolic blood pressure was closely correlated with high ABI in non-dialyzed CKD patients (β = 0.059, P = 0.001). But in PD patients, serum calcium had a crucial effect on high ABI (β = −9.853, P < 0.001). Additionally, PD patients with high ABI tended to dialyze inadequately (Kt/V <1.7) compared to those with normal ABI (29.0 vs. 13.3%, P = 0.031). Further mediation analysis revealed that ~86.2% of the relationship between Kt/V and high ABI was mediated by serum calcium in PD patients (mediation effect = 86.2%, ab = −0.220, 95% CI: −0.381 to −0.059, P = 0.008), especially in those starting PD before 55 years of age and with normal body mass index. This present study indicated that improvement of PD adequacy by maintaining calcium balance might be a promising method to reduce the risk of MACE estimated by high ABI for PD patients.
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spelling pubmed-93692532022-08-12 Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis Su, Xiaoyan He, Wanbing Zhang, Mengbi Zhang, Yinyin Zhu, Langjing Chen, Jie Huang, Hui Front Cardiovasc Med Cardiovascular Medicine Cardiovascular disease (CVD) is the leading cause of death in peritoneal dialysis (PD) patients. But the relationship between regular PD and the risk of major adverse cardiovascular events (MACE) remains controversial. The possible risk factors are not fully elucidated. This study aims to investigate the possible factors affecting the risk of MACE estimated by high ankle-brachial index (ABI) in PD patients. A total of 243 patients were enrolled and divided into chronic kidney diseases (CKD) stage 1, non-dialyzed CKD stages 2–5, and PD groups. The prevalence of high ABI, indicating increased MACE, was elevated with CKD progression but not further increased in PD patients. Systolic blood pressure was closely correlated with high ABI in non-dialyzed CKD patients (β = 0.059, P = 0.001). But in PD patients, serum calcium had a crucial effect on high ABI (β = −9.853, P < 0.001). Additionally, PD patients with high ABI tended to dialyze inadequately (Kt/V <1.7) compared to those with normal ABI (29.0 vs. 13.3%, P = 0.031). Further mediation analysis revealed that ~86.2% of the relationship between Kt/V and high ABI was mediated by serum calcium in PD patients (mediation effect = 86.2%, ab = −0.220, 95% CI: −0.381 to −0.059, P = 0.008), especially in those starting PD before 55 years of age and with normal body mass index. This present study indicated that improvement of PD adequacy by maintaining calcium balance might be a promising method to reduce the risk of MACE estimated by high ABI for PD patients. Frontiers Media S.A. 2022-07-28 /pmc/articles/PMC9369253/ /pubmed/35966542 http://dx.doi.org/10.3389/fcvm.2022.920431 Text en Copyright © 2022 Su, He, Zhang, Zhang, Zhu, Chen and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Su, Xiaoyan
He, Wanbing
Zhang, Mengbi
Zhang, Yinyin
Zhu, Langjing
Chen, Jie
Huang, Hui
Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title_full Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title_fullStr Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title_full_unstemmed Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title_short Abnormal Calcium Metabolism Mediated Increased Risk of Cardiovascular Events Estimated by High Ankle-Brachial Index in Patients on Peritoneal Dialysis
title_sort abnormal calcium metabolism mediated increased risk of cardiovascular events estimated by high ankle-brachial index in patients on peritoneal dialysis
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369253/
https://www.ncbi.nlm.nih.gov/pubmed/35966542
http://dx.doi.org/10.3389/fcvm.2022.920431
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