Reduced residual renal function is associated with endothelial dysfunction in patients receiving peritoneal dialysis

SeungHyeok Han, Sang Choel Lee, Ea Wha Kang, Jung Kyung Park, Hyang Sook Yoon, TaeHyun Yoo, Kyu Hun Choi, Dae Suk Han, Shin-Wook Kang

Research output: Contribution to journalArticle

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Abstract

Background: Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD). Methods: This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia. Results: In patients with FMD% above the median value (FMD > 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m 2, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (y= 0.408, P < 0.001) were positively correlated with FMD%, whereas PD duration (y = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (y = -0.341, P = 0.003), and age (y = -0.403, P < 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% ((3 = 0.317, P = 0.017). Conclusion: This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.

Original languageEnglish
Pages (from-to)149-158
Number of pages10
JournalPeritoneal Dialysis International
Volume32
Issue number2
DOIs
Publication statusPublished - 2012 Mar 1

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Peritoneal Dialysis
Dilatation
Kidney
Glomerular Filtration Rate
Chronic Kidney Failure
Urea
Brachial Artery
Arteriosclerosis
Hyperemia
Forearm
Vasodilation
C-Reactive Protein
Endothelium
Linear Models
Atherosclerosis
Ischemia
Cross-Sectional Studies
Regression Analysis
Demography
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Han, SeungHyeok ; Lee, Sang Choel ; Kang, Ea Wha ; Park, Jung Kyung ; Yoon, Hyang Sook ; Yoo, TaeHyun ; Choi, Kyu Hun ; Han, Dae Suk ; Kang, Shin-Wook. / Reduced residual renal function is associated with endothelial dysfunction in patients receiving peritoneal dialysis. In: Peritoneal Dialysis International. 2012 ; Vol. 32, No. 2. pp. 149-158.
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abstract = "Background: Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD). Methods: This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia. Results: In patients with FMD{\%} above the median value (FMD > 2.41{\%}), residual GFR was significantly higher compared to that in patients with FMD{\%} below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m 2, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (y= 0.408, P < 0.001) were positively correlated with FMD{\%}, whereas PD duration (y = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (y = -0.341, P = 0.003), and age (y = -0.403, P < 0.001) were inversely correlated with FMD{\%}. In contrast, there was no correlation between peritoneal Kt/V urea and FMD{\%}. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD{\%} ((3 = 0.317, P = 0.017). Conclusion: This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.",
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Reduced residual renal function is associated with endothelial dysfunction in patients receiving peritoneal dialysis. / Han, SeungHyeok; Lee, Sang Choel; Kang, Ea Wha; Park, Jung Kyung; Yoon, Hyang Sook; Yoo, TaeHyun; Choi, Kyu Hun; Han, Dae Suk; Kang, Shin-Wook.

In: Peritoneal Dialysis International, Vol. 32, No. 2, 01.03.2012, p. 149-158.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reduced residual renal function is associated with endothelial dysfunction in patients receiving peritoneal dialysis

AU - Han, SeungHyeok

AU - Lee, Sang Choel

AU - Kang, Ea Wha

AU - Park, Jung Kyung

AU - Yoon, Hyang Sook

AU - Yoo, TaeHyun

AU - Choi, Kyu Hun

AU - Han, Dae Suk

AU - Kang, Shin-Wook

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Background: Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD). Methods: This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia. Results: In patients with FMD% above the median value (FMD > 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m 2, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (y= 0.408, P < 0.001) were positively correlated with FMD%, whereas PD duration (y = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (y = -0.341, P = 0.003), and age (y = -0.403, P < 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% ((3 = 0.317, P = 0.017). Conclusion: This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.

AB - Background: Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD). Methods: This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia. Results: In patients with FMD% above the median value (FMD > 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m 2, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (y= 0.408, P < 0.001) were positively correlated with FMD%, whereas PD duration (y = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (y = -0.341, P = 0.003), and age (y = -0.403, P < 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% ((3 = 0.317, P = 0.017). Conclusion: This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.

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