ENDOTHELIUM-DEPENDENT VASODILATATION IS IMPAIRED IN PERITONEAL-DIALYSIS PATIENTS

Background. Peritoneal dialysis (PD) patients have a high risk of card iovascular mortality, which is not completely explained by conventiona l risk factors. Other factors related to chronic renal failure and/or dialysis treatment might lead to endothelial dysfunction, which is ass ociated with an adverse cardiovascular outcome. One such factor is hyp erhomocysteinaemia, which has a high prevalence in PD patients. Method s. A vessel wall movement detector system was used to investigate endo thelium-dependent: flow-mediated, and endothelium-independent. glycery l trinitrate-induced, vasodilatation of the brachial artery in 29 PD p atients and 29 control subjects. Results, Endothelium-dependent vasodi latation was markedly reduced in the PD group: 5.7 +/- 1.0% vs 10.4 +/ - 1.3% in the control group (P=0.004), Endothelium-independent vasodil atation was not impaired. Plasma total homocysteine was elevated in th e PD patients (45.2 +/- 6.2 mu mol/l): but was not related to endothel ium-dependent vasodilatation. Conclusion. Chronic peritoneal dialysis patients have impaired endothelium-dependent vasodilatation, which may reflect an increased susceptibility for the development of atheroscle rosis and thrombosis.