Jun 2016 DOI 10.14302/issn.2329-9487.jhc-15-905
D. Raikou VaiaCorresponding author
Dpt of Medicine - Propaedaetic, National & Kapodistrian University of Athens, School of Medicine.
Backgroud: Metabolic acidosis, a common condition particularly in end stage renal disease patients, results in malnutrition and inflammation. In this study, we focused on the importance of metabolic acidosis on manifestations of cardiovascular disease in patients on peritoneal dialysis. Methods: We studied 20 patients on continuous ambulatory peritoneal dialysis (CAPD), 15 males and 5 females, on mean age 61.6 ±11.3 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22mmol/L, which were measured in gas machine. Dialysis adequacy was defined by total Kt/V/week for urea including peritoneal Kt/V for urea and residual GFR (ml/min/1.73m2). High sensitivity C-reactive protein (hsCRP) was measured using enzyme linked immunoabsorbed assay (ΕLISA). The concentrations of intact-parathormone (i-PTH) and beta2-microglobulin (beta2M) were measured by radioimmunoassays. Arterial stiffness was measured as carotid-femoral pulse wave velocity (c-f PWV) and augmentation index (AIx). We built a Cox regression analysis to predict coronary artery disease (CAD), congestive heart failure (CHF) and peripheral vascular disease (PVD). Results: Serum bicarbonate levels were inversely associated to beta2M, i-PTH and AIx (r=-0.451, p=0.04, r=-0.477, p=0.03 and r=-0.569, p=0.009 respectively). Cox- regression analysis revealed significant association of serum bicarbonate levels and PVD having as confounders traditional and specific for these patients risk factors. Conclusion: Metabolic acidosis may be an independent risk factor for arterial stiffening and peripheral vascular disease manifestation in patients on peritoneal dialysis.
May 2015 DOI 10.14302/issn.2470-5020.jnrt-14-558
Enrique Jiménez Caballero PedroCorresponding author
Department of Neurology, San Pedro de Alcántara Hospital, Avenida de Pablo Naranjo nº 2, 10003. Cáceres. Spain.
Background. Endothelial function is characterized by the vasodilator capacity of blood vessel smooth muscle cells mediated by nitric oxide. Some studies have shown an inverse association between the endothelial function and the carotid intima-media thickness (IMT). The relationship between endothelial dysfunction and stroke based on several studies has shown that is altered in all stroke subtypes especially lacunar strokes. Methods. We aimed to investigate endothelial function by EndoPAT device in relation to stroke subtypes. We investigate too the correlations between endothelial function and IMT and we study possible interactions with age, sex, traditional risk factors and severity of stroke. Subsequent patients with acute ischemic stroke were enrolled. They were divided according with the etiological mechanism of stroke (TOAST classification). Endothelial function was assessed with finger plethysmography by the EndoPAT device that gave Reactive Hyperemia Index (RHI) and Augmentation Index (AI). Results. Patients with a cardioembolic stroke had a RHI higher than atherotrombotic or lacunar stroke. There was a negative correlation between RHI and IMT and positive between AI and age. Conclusions. The endothelial function is different between stroke subtypes with higher values of RHI in the cardioembolic respect to lacunar or atherotrombotic. The RHI is correlated with the atherosclerosis by the negative relationship with the IMT. The AI that shows the rigidity in the arteries increased with the age.