| Theme |
The impact of bone and Ca/Pi metabolism on vascular disease |
| Title |
Cardiovascular complications in peritoneal dialysis patients -- heart failure and metastatic calcification |
| Author |
Hiroshige Ohashi |
Division of Nephrology, Prefectural Gifu Hospital |
| Author |
Hiroshi Oda |
Division of Nephrology, Prefectural Gifu Hospital |
| Author |
Michiya Ohno |
Division of Nephrology, Prefectural Gifu Hospital |
| Author |
Urara Mori |
Division of Nephrology, Prefectural Gifu Hospital |
| [ Summary ] |
Cardiovascular disease is the most common cause of mortality and morbidity in dialysis patients. In peritoneal dialysis (PD) patients, clinical data evaluating cardiovascular complications are sparse compared to that available for hemodialysis patients. We evaluated cardiovascular complications in PD patients from the view point of heart failure, cardiac valve calcification, and carotid atherosclerosis.
The prevalence of left ventricular hypertrophy (LVH) is high in PD patients. PD patients with LVH showed impaired sympathetic nerve activity and fatty acid metabolism of the myocardium. It was suggested that coronary atherosclerosis and LVH accounted for the onset of heart failure. Inflammation played an important role in cardiac valve calcification and carotid atherosclerosis. The levels of C-reactive protein, lipoprotein (a), homocysteine and fibrinogen were higher in PD patients with cardiac valve calcification and carotid atherosclerosis. Because it has been suggested recently that bone marrow derived cells participate in cardiac valve calcification and atherosclerosis, it is necessary to evaluate these complications from such a point of view. |