[Analysis of some risk factors of coronary artery calcification in peritoneal dialysis patients]. / Badanie niektórych czynników ryzyka kalcyfikacji naczyn wiencowych u pacjentów leczonych dializa otrzewnowa.

Cardiovascular disease (CVD) is a major cause of death in peritoneal dialysed patients (PD-pts). Coronary artery calcification (CAC) is likely to affect the development of CVD. Purpose of our study was to evaluate coronary artery calcification and risk factors of this calcification in PD-pts. We studied 62 patients (38 F, 24 M) undergoing peritoneal dialysis (PD). Coronary calcification was examined by ECG-gated multidetector CT (Light Speed Ultra) using Agatson (AG) and volumetric (V) methods. Patients were divided into 3 groups depending on mean value of estimated CAC: group A-no calcification, group B-CAC maximal value 400 mm3, group C-CAC value more than 400 mm3. As risk factors of CAC were evaluated: patients age, sex, dialysis duration, serum concentration of Ca, P, homocysteine CRP and fibrinogen, as well as, CaxP product, intact PTH; presence of diabetes or hypertension. Coronary artery calcification was detected in 68% of patients. In the whole observed population positive correlation between CAC determined by AG and V methods and CRP (r = 0.36, p < 0.05) as well as patients age (r = 0.5, p < 0.01) was observed. There was also positive correlation between CAC and fibrinogen concentration (AG CAC r = 0.58, p < 0.05; V CAC r = 0.72, p < 0.05). When compared group C with the groups A and B cardiovascular complications were in this group more frequent than in the last two: 4 patients from group C died because of cardiovascular complications.

Comparison between some anthropometric measurements in adequately treated peritoneal dialysis and hemodialysis patients.

Some anthropometric measurements are usually used to estimate the nutritional status of dialysis patients. The aim of our study was the comparison of some anthropometric measurements in patients adequately (from the clinical point of view) treated with peritoneal dialysis (PD) and hemodialysis (HD). The study was performed on 40 chronic dialysis (both: PD and HD), non-diabetic patients, without any inflammatory process. The patients were divided into two groups, 20 patients in each: I peritoneal dialysis patients (PD-pts), II--hemodialysis patients (HD-pts). In each patient body mass index (BMI), total body water (TBW), lean body mass (LBM), fat body mass (FBM), upper limb musculature (ULM), mid arm circumference in tension and in rest MAC-t and MAC-r), triceps skinfold thickness (TSF) and dialysis index (Kt/V) were determined. The obtained values were analyzed statistically and compared between the groups. In peritoneal dialysis the patients' higher values of BMI, FBM, MAC and TSF (p < 0.01), as well as higher LBM and ULM (p < 0.05) than those in hemodialysis patients were observed. TBW was not statistically different in the PD and HD patients (p > 0.05). Mean Kt/V values observed were as follows: 2.16 +/- 0.48 in PD patients vs 1.05 +/- 0.35 in the HD patients; (p < 0.01). We conclude that adequately treated, from the clinical point of view the PD patients had better anthropometric indicators of nutritional status than the adequately treated HD patients.