High-Density Lipoprotein Cholesterol and Left Ventricular Mass Index in Peritoneal Dialysis

2008 ◽  
Vol 28 (6) ◽  
pp. 611-616 ◽  
Author(s):  
Ryota Ikee ◽  
Yoshifumi Hamasaki ◽  
Machiko Oka ◽  
Kyoko Maesato ◽  
Tsutomu Mano ◽  
...  

Objective The prevalence of left ventricular hypertrophy (LVH) reaches 75% in patients with end-stage renal disease. In patients on peritoneal dialysis (PD), some factors, such as hypertension, volume overload, serum albumin, and residual renal function, have been reported to be related to LVH. Dyslipidemia often occurs in PD but it remains unclear whether dyslipidemia is related to LVH. We investigated the relationship between clinical parameters, including lipid profile, and left ventricular mass index (LVMI). Methods In this cross-sectional study, 34 patients undergoing PD for more than 1 year without combined therapy with hemodialysis were included. We recorded the patients’ clinical data and related those parameters with LVMI as evaluated by echocardiography. Results The patients included 23 males and 11 females (age 62.2 ± 12.1 years, duration on PD 31.6 ± 15.6 months). Mean LVMI was 142 ± 37 g/m2. In univariate analysis, urine volume ( r = -0.493, p = 0.003), total cholesterol ( r = -0.418, p = 0.01), high-density lipoprotein cholesterol (HDL-C; r = -0.374, p = 0.02), and human atrial natriuretic peptide (hANP; r = 0.600, p < 0.001) significantly correlated with LVMI. Stepwise multiple regression analysis showed that hANP (β= 0.524, p = 0.001) and HDL-C (β= -0.422, p = 0.007) were independently associated with LVMI ( r2 = 0.32). Conclusion Strict volume control and salt restriction is essential for prevention of LVH. The role of HDL-C in the development of LVH in PD patients remains to be determined.

1995 ◽  
Vol 88 (4) ◽  
pp. 427-432 ◽  
Author(s):  
Jorma T. Lahtela ◽  
Jukka Mustonen ◽  
Amos Pasternack

1. The metabolic effects of intraperitoneal and subcutaneous insulin delivery were compared in a crossover manner in six C-peptide-negative diabetic patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Each treatment period lasted at least 3 months. Hyperinsulinaemic euglycaemic clamp was performed and glucose turnover assessed using [3-3H]glucose as a tracer. 2. During intraperitoneal delivery the daily insulin dose was 2.4 times higher than during subcutaneous administration and glycaemic control was significantly better (HbA1c 7.63% ± 0.46% and 9.52% ± 0.51% during intraperitoneal and subcutaneous insulin respectively, P < 0.01). The number of hypoglycaemic episodes was lower during intraperitoneal insulin than during subcutaneous therapy. 3. Intraperitoneal insulin resulted in an enhanced glucose disposal rate (P < 0.01) and reduced fasting hepatic glucose production (P < 0.01). High-density lipoprotein-cholesterol decreased and the ratio of low-density lipoprotein/high-density lipoprotein-cholesterol increased significantly (P < 0.05) during intraperitoneal insulin delivery. 4. The results suggest that intraperitoneal insulin, while resulting in better glycaemic control and improved insulin sensitivity than subcutaneous insulin, increases serum triacylglycerol and total cholesterol and reduces high-density lipoprotein-cholesterol, possibly via a direct effect on the liver.


2022 ◽  
Author(s):  
Rui Zhang ◽  
Xing Zhang ◽  
Xingming Tang ◽  
Liwen Tang ◽  
Sijia Shang ◽  
...  

Abstract BackgroundLow levels of high-density lipoprotein-cholesterol (HDL-C) and diabetes are common in patients undergoing peritoneal dialysis (PD). The aim of this study was to investigate the association between diabetes coexisting with a low level of HDL-C and the first episode of peritoneal dialysis-related peritonitis (PDRP) in patients with PD.MethodsWe retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020 in four PD centers. Patients with PD were divided into four groups: no comorbidity, low HDL-C only, diabetes only, and diabetes plus low HDL-C. The clinical and laboratory baseline data of the four groups were collected and compared. The association between diabetes coexisting with low HDL-C levels and the first episode of PDRP was analysed by multivariate Cox regression analysis. ResultsA total of 1013 patients with PD were recorded in our study. The mean age was 49.94±14.32 years, and 597 (58.99%) were males. A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels existed with diabetes in 72 patients with PD. After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 1.93, 95% CI: 1.03-3.61, p<0.05). The associations between HDL-C, diabetes and PDRP were consistent in the following subgroups: sex, age, pre-existing CVD (all P interaction > 0.05).ConclusionsLow levels of HDL-C alone or diabetes alone were not independent risk factors for PDRP. Patients with both diabetes and low HDL-C levels were at high risk for PDRP.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiaojiang Zhan ◽  
Mei Yang ◽  
Ruitong Zhou ◽  
Xin Wei ◽  
Yanbing Chen ◽  
...  

Abstract Background The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been suggested as a simple method to identify unfavorable cardiovascular (CV) outcomes in the general population. The aim of this study was to investigate the association between the TG/HDL-C ratio and all-cause and CV mortality in peritoneal dialysis (PD) patients. Methods We retrospectively analyzed patients on PD from November 1, 2005, to February 28, 2017, with a follow-up period lasting until May 31, 2017. The main outcomes were all-cause and CV mortality. Results Among the 973 PD patients, the mean age was 49.67 ± 14.58 (y). During a median follow-up period of 27.2 months (IQR = 13.4–41.5 months), 229 (23.5%) patients died, with 120 (12.3%) dying as a result of CV diseases. The median serum TG/HDL-C ratio was 1.11 (IQR = 0.71–1.80). In a multivariate Cox regression analysis, patients with higher TG/HDL-C ratio levels (tertile 3) had a higher incidence of CV mortality (adjusted HR = 2.12; 95% CI: 1.21–3.72; P = 0.009) and all-cause mortality (adjusted HR = 2.08; 95% CI: 1.37–3.14; P = 0.001) compared to patients in tertile 1. These associations persisted after excluding the patients who have already taken lipid-lowering medications. For older patients (> 60 years), each 1-unit higher baseline TG/HDL-C level was associated with a 48% (95% CI: 1.06–2.07; P = 0.021) increased risk of all-cause mortality and a 59% (95% CI: 1.03–2.45; P = 0.038) increased risk of CV mortality; however, this association was not observed in patients ≤60 years of age. Conclusions A higher serum TG/HDL-C ratio was an independent predictor of all-cause and CV mortality in PD patients. Furthermore, an elevated TG/HDL-C ratio was significantly associated with higher all-cause and CV mortality in older PD patients.


2001 ◽  
Vol 19 (12) ◽  
pp. 2265-2270 ◽  
Author(s):  
Giuseppe Schillaci ◽  
Gaetano Vaudo ◽  
Gianpaolo Reboldi ◽  
Paolo Verdecchia ◽  
Graziana Lupattelli ◽  
...  

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