Strong association between nutritional markers and arterial stiffness in continuous ambulatory peritoneal dialysis patients

Abstract

Background: Malnutrition is a predictor of cardiovascular disease in dialysis patients, but the mechanisms remain unknown. We investigated links between nutritional markers and arterial stiffness in continuous ambulatory peritoneal dialysis patients. Methods: We evaluated the relationship between arterial stiffness evaluated by pulse-wave velocity (PWV) and four estimates of nutritional status (serum albumin, handgrip strength [HGS], subjective global assessment [SGA], and bioelectrical impedance analysis phase angle [PA]) in 124 PD patients. Results: Malnourished patients exhibited a significantly higher PWV than those classified as well- nourished by SGA (p < 0.05). Furthermore, PWV correlated negatively with albumin, HGS and PA (p < 0.001, respectively). PWV was also correlated with age, systolic blood pressure, and C- reactive protein. In multivariate regression analysis, albumin, HGS, SGA and PA were each independently associated with PWV after adjustment. Conclusions: The significant association between each nutritional marker and PWV in PD patients was independent of inflammation and diabetic state, suggesting that malnutrition may contribute to vascular dysfunction. Copyright (c) 2008 S. Karger AG, Basel.