TY  - JOUR
AU  - Stanković-Popović, Verica
AU  - Popović, Dragan
AU  - Dimković, Nada
AU  - Maksić, Đoko
AU  - Vasilijić, Saša
AU  - Čolić, Miodrag
AU  - Vučinić, Žarko
AU  - Rađen, Slavica
AU  - Miličić, Biljana
PY  - 2013
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/1774
AB  - Background/Aim. Morbidity and mortality of continous ambulatory peritoneal dialysis (CAPD) patients is still very high. The aim of the study was to evaluate the effects of peritoneal dialysis (PD) solutions (standard vs biocompatible) on long-term patients' and the techique survival. Methods. A total of 42 stable patients on CAPD participated in this crosssectional study. They were prospectively followed-up during the twelve years. Patients with severe anemia (Hb  lt  10 g/L) and malignant disease ware excluded. Twenty one (50%) patients were treated with the standard PD solutions (CAPDP- 1) while the other 21 (50%) were treated with biocompatible PD solutions [(lower level of glucose degradation products, lower concentration of Ca2+ and neutral pH (CAPDP-2)]. All patients were analyzed for a presence of vascular calcification, nutrition status, and parameters of inflammation after 2.5 ± 0.6 years of starting CAPD, and these variables considered in the analysis as risk factors. Results. The patients from the group CAPDP-2 compared to those from the group CAPDP-1 had lower level of high-sensitivity C-reactive protein (hs-CRP) (p = 0.003), and better nutritional status as confirmed by the mid-arm circumference (p = 0.015), and midarm muscle circumference (p = 0.002) and subjective global assessment (p = 0.000). Also, they had lower vascular calcifications as confirmed by intima media thickness (IMT) (p = 0.003), degree of carotid narrowing (p = 0.001) and calcified plaques of common carotid arteries (CCA) (p = 0.008). Kaplan- Meier analysis confirmed better survival of patients from the group CAPDP-2 than those from the group CAPDP-1 (1-, 5-, and 10-year patients survival rate was: 100%, 61.9% and 14.3% for the group CAPDP-1, and 100%, 85.7%, and 52.4% for the group CAPDP-2, respectively; p = 0.0345). The 1-, 5-, and 10-year technique survival rate was: 100%, 71.4%, and 38.1% for the group CAPDP-1, and 100%, 85.7%, and 76.2% for the group CAPDP-2, respectively; (p = 0.0719). Duration of dialysis, serum triglyceride and cardiovascular score (quantitative scoring system consisting of: ejection fraction (EF) of left ventricle  lt  50%; IMT > 1 mm; carotid narrowing degree > 50%, presence of carotid plaques in both common carotide, ischaemic heart disease, cerebrovascular event and peripheral vascular disease with or without amputation) were independent predictors of overall patient survival. Duration of dialysis was only independent predictor of overall technique survival. Conclusion. Although patients treated with biocompatible solutions showed significantly better survival, the role of biocompatibility of CAPD solutions in patients and technique survival have to be confirmed. Namely, multivariate analysis confirmed that duration of dialysis, serum triglyceride and cardiovascular score significantly predicted overall CAPD patients survival, while only duration of dialysis was found to be independent predictor of overall technique survival.
AB  - Uvod/Cilj. Morbiditet i mortalitet bolesnika na kontinuiranoj ambulantnoj peritoneumskoj dijalizi (KAPD) i dalje je neprihvatljivo visok. Cilj rada bio je da se proceni uticaj vrste dijaliznih rasvora (bioinkompatibilni vs biokompatibilni) na višegodišnje preživljavanje bolesnika i same tehnike KAPD. Metode. Ovom studijom preseka sa delimično prospektivnim praćenjem ishoda lečenja obuhvaćeno je ukupno 42 nasumice izabrana, stabilna bolesnika (26 muškaraca i 16 žena) lečena primenom metode KAPD tokom poslednjih 12 godina. Isključeni su bolesnici sa teškom anemijom (Hb  lt 10 g/L) i malignom bolešću. Pri tome, 21 (50%) bolesnika kontinuirano je lečeno bioinkompatibilnim rastvorom za KAPD (kiseli standardni rastvor - ANDY-disc; grupa KAPDB-1), dok je preostalih 21 bolesnik sve vreme bilo na biokompatibilnijem rastvoru za KAPD (neutralni rastvor sa znatno manjom koncentracijom degradacionih produkata glukoze, 1.25 mmol/L Ca i 40 mmol/L laktata - Gambrosol Trio; grupa KAPDB-2). Svim bolesnicima određeni su odabrani parametri hronične inflamacije, malnutricije i ateroskleroze zajedno sa transportnim karakteristikama peritoneumske membrane i rezidualnom bubrežnom funkcijom nakon 2,5 ± 0,6 god od započinjanja KAPD. Svi dobijeni rezultati analizirani su kao potencijalni faktori rizika. Rezultati. Grupa KAPDB-2 u odnosu na KAPDB-1 imala je statistički značajno niže vrednosti serumskog hs-CRP (p = 0,003) i bolje parametre nutritivnog statusa izražene kroz obim nadlaktice (p = 0,015), obim mišića nadlaktice (p = 0,002) i subjektivnu globalnu procenu (p = 0,000) kao i u manjoj meri prisutnu aterosklerozu potvrđeno debljinom intimomedijalnog kompleksa (IMT) (p = 0,003), stepenom suženja karotida (p = 0,001) i prisustvom kalcifikovanih ateromatoznih plakova na karotidnim arterijama (p = 0,008). Kaplan-Meier-ova kriva preživljavanja potvrdila je značajno duže preživljavanje bolesnika u grupi KAPD-2 u odnosu na KAPDB-1 (1-, 5-, i 10-godišnje preživljavanje bolesnika iznosilo je redom: 100%, 61.9% i 14.3% u KAPDB-1, a 100%, 85,7% i 52,4% u KAPDB-2 grupi; p = 0,0345). Stopa 1-, 5-, i 10-godišnjeg preživljavanja metode iznosila je: 100%, 71,4% i 38,1% u KAPDB-1, a 100%, 85,7% i 76,2% u KAPDB-2 grupi (p = 0,0719). Kao nezavisni prediktori opšteg preživljavanja bolesnika na KAPD izdvojili su se: dijalizni staž, nivo serumskih triglicerida i skor kardiovaskularnog morbiditeta (kvantitativni sistem zbrajanja prisutnih sledećih parametara: ejekciona frakcija (EF) leve komore  lt  50%; IMT >1 mm; suženje lumena karotida > 50%; kalcifikovani ateromatozni plakovi na obe karotide; ishemijska bolest srca; cerebrovaskularni događaj i periferna vaskularna bolest sa ili bez gangrene). Kao nezavisan prediktor preživljavanja metode izdvojio se jedino dijalizni staž. Zaključak. Iako su bolesnici na KAPD sa biokompatibilnijim rastvorima pokazali statistički značajno bolje preživljavanje, ne možemo tvrditi da bioinkompatibilnost dijaliznih rastvora predstavlja značajan faktor rizika od preživljavanja bolesnika i same metode lečenja. Naime, multivarijantnom analizom kao prediktori opšteg preživljavanja bolesnika izdvojili su se samo dijalizni staž, nivo serumskih triglicerida i skor kardiovaskularnog morbiditeta, dok se za očuvanje peritoneumske membrane kao nezavisan faktor rizika prikazao samo dijalizni staž.
PB  - Vojnomedicinska akademija - Institut za naučne informacije, Beograd
T2  - Vojnosanitetski pregled
T1  - Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself
T1  - Uticaj biokompatibilnosti rastvora za peritoneumsku dijalizu na višegodišnje preživljavanje bolesnika na kontinuiranoj ambulantnoj peritoneumskoj dijalizi i same metode lečenja
VL  - 70
IS  - 4
SP  - 352
EP  - 362
DO  - 10.2298/VSP1304352S
ER  - 

@article{
author = "Stanković-Popović, Verica and Popović, Dragan and Dimković, Nada and Maksić, Đoko and Vasilijić, Saša and Čolić, Miodrag and Vučinić, Žarko and Rađen, Slavica and Miličić, Biljana",
year = "2013",
abstract = "Background/Aim. Morbidity and mortality of continous ambulatory peritoneal dialysis (CAPD) patients is still very high. The aim of the study was to evaluate the effects of peritoneal dialysis (PD) solutions (standard vs biocompatible) on long-term patients' and the techique survival. Methods. A total of 42 stable patients on CAPD participated in this crosssectional study. They were prospectively followed-up during the twelve years. Patients with severe anemia (Hb  lt  10 g/L) and malignant disease ware excluded. Twenty one (50%) patients were treated with the standard PD solutions (CAPDP- 1) while the other 21 (50%) were treated with biocompatible PD solutions [(lower level of glucose degradation products, lower concentration of Ca2+ and neutral pH (CAPDP-2)]. All patients were analyzed for a presence of vascular calcification, nutrition status, and parameters of inflammation after 2.5 ± 0.6 years of starting CAPD, and these variables considered in the analysis as risk factors. Results. The patients from the group CAPDP-2 compared to those from the group CAPDP-1 had lower level of high-sensitivity C-reactive protein (hs-CRP) (p = 0.003), and better nutritional status as confirmed by the mid-arm circumference (p = 0.015), and midarm muscle circumference (p = 0.002) and subjective global assessment (p = 0.000). Also, they had lower vascular calcifications as confirmed by intima media thickness (IMT) (p = 0.003), degree of carotid narrowing (p = 0.001) and calcified plaques of common carotid arteries (CCA) (p = 0.008). Kaplan- Meier analysis confirmed better survival of patients from the group CAPDP-2 than those from the group CAPDP-1 (1-, 5-, and 10-year patients survival rate was: 100%, 61.9% and 14.3% for the group CAPDP-1, and 100%, 85.7%, and 52.4% for the group CAPDP-2, respectively; p = 0.0345). The 1-, 5-, and 10-year technique survival rate was: 100%, 71.4%, and 38.1% for the group CAPDP-1, and 100%, 85.7%, and 76.2% for the group CAPDP-2, respectively; (p = 0.0719). Duration of dialysis, serum triglyceride and cardiovascular score (quantitative scoring system consisting of: ejection fraction (EF) of left ventricle  lt  50%; IMT > 1 mm; carotid narrowing degree > 50%, presence of carotid plaques in both common carotide, ischaemic heart disease, cerebrovascular event and peripheral vascular disease with or without amputation) were independent predictors of overall patient survival. Duration of dialysis was only independent predictor of overall technique survival. Conclusion. Although patients treated with biocompatible solutions showed significantly better survival, the role of biocompatibility of CAPD solutions in patients and technique survival have to be confirmed. Namely, multivariate analysis confirmed that duration of dialysis, serum triglyceride and cardiovascular score significantly predicted overall CAPD patients survival, while only duration of dialysis was found to be independent predictor of overall technique survival., Uvod/Cilj. Morbiditet i mortalitet bolesnika na kontinuiranoj ambulantnoj peritoneumskoj dijalizi (KAPD) i dalje je neprihvatljivo visok. Cilj rada bio je da se proceni uticaj vrste dijaliznih rasvora (bioinkompatibilni vs biokompatibilni) na višegodišnje preživljavanje bolesnika i same tehnike KAPD. Metode. Ovom studijom preseka sa delimično prospektivnim praćenjem ishoda lečenja obuhvaćeno je ukupno 42 nasumice izabrana, stabilna bolesnika (26 muškaraca i 16 žena) lečena primenom metode KAPD tokom poslednjih 12 godina. Isključeni su bolesnici sa teškom anemijom (Hb  lt 10 g/L) i malignom bolešću. Pri tome, 21 (50%) bolesnika kontinuirano je lečeno bioinkompatibilnim rastvorom za KAPD (kiseli standardni rastvor - ANDY-disc; grupa KAPDB-1), dok je preostalih 21 bolesnik sve vreme bilo na biokompatibilnijem rastvoru za KAPD (neutralni rastvor sa znatno manjom koncentracijom degradacionih produkata glukoze, 1.25 mmol/L Ca i 40 mmol/L laktata - Gambrosol Trio; grupa KAPDB-2). Svim bolesnicima određeni su odabrani parametri hronične inflamacije, malnutricije i ateroskleroze zajedno sa transportnim karakteristikama peritoneumske membrane i rezidualnom bubrežnom funkcijom nakon 2,5 ± 0,6 god od započinjanja KAPD. Svi dobijeni rezultati analizirani su kao potencijalni faktori rizika. Rezultati. Grupa KAPDB-2 u odnosu na KAPDB-1 imala je statistički značajno niže vrednosti serumskog hs-CRP (p = 0,003) i bolje parametre nutritivnog statusa izražene kroz obim nadlaktice (p = 0,015), obim mišića nadlaktice (p = 0,002) i subjektivnu globalnu procenu (p = 0,000) kao i u manjoj meri prisutnu aterosklerozu potvrđeno debljinom intimomedijalnog kompleksa (IMT) (p = 0,003), stepenom suženja karotida (p = 0,001) i prisustvom kalcifikovanih ateromatoznih plakova na karotidnim arterijama (p = 0,008). Kaplan-Meier-ova kriva preživljavanja potvrdila je značajno duže preživljavanje bolesnika u grupi KAPD-2 u odnosu na KAPDB-1 (1-, 5-, i 10-godišnje preživljavanje bolesnika iznosilo je redom: 100%, 61.9% i 14.3% u KAPDB-1, a 100%, 85,7% i 52,4% u KAPDB-2 grupi; p = 0,0345). Stopa 1-, 5-, i 10-godišnjeg preživljavanja metode iznosila je: 100%, 71,4% i 38,1% u KAPDB-1, a 100%, 85,7% i 76,2% u KAPDB-2 grupi (p = 0,0719). Kao nezavisni prediktori opšteg preživljavanja bolesnika na KAPD izdvojili su se: dijalizni staž, nivo serumskih triglicerida i skor kardiovaskularnog morbiditeta (kvantitativni sistem zbrajanja prisutnih sledećih parametara: ejekciona frakcija (EF) leve komore  lt  50%; IMT >1 mm; suženje lumena karotida > 50%; kalcifikovani ateromatozni plakovi na obe karotide; ishemijska bolest srca; cerebrovaskularni događaj i periferna vaskularna bolest sa ili bez gangrene). Kao nezavisan prediktor preživljavanja metode izdvojio se jedino dijalizni staž. Zaključak. Iako su bolesnici na KAPD sa biokompatibilnijim rastvorima pokazali statistički značajno bolje preživljavanje, ne možemo tvrditi da bioinkompatibilnost dijaliznih rastvora predstavlja značajan faktor rizika od preživljavanja bolesnika i same metode lečenja. Naime, multivarijantnom analizom kao prediktori opšteg preživljavanja bolesnika izdvojili su se samo dijalizni staž, nivo serumskih triglicerida i skor kardiovaskularnog morbiditeta, dok se za očuvanje peritoneumske membrane kao nezavisan faktor rizika prikazao samo dijalizni staž.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself, Uticaj biokompatibilnosti rastvora za peritoneumsku dijalizu na višegodišnje preživljavanje bolesnika na kontinuiranoj ambulantnoj peritoneumskoj dijalizi i same metode lečenja",
volume = "70",
number = "4",
pages = "352-362",
doi = "10.2298/VSP1304352S"
}

Stanković-Popović, V., Popović, D., Dimković, N., Maksić, Đ., Vasilijić, S., Čolić, M., Vučinić, Ž., Rađen, S.,& Miličić, B.. (2013). Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself. in Vojnosanitetski pregled
Vojnomedicinska akademija - Institut za naučne informacije, Beograd., 70(4), 352-362.
https://doi.org/10.2298/VSP1304352S

Stanković-Popović V, Popović D, Dimković N, Maksić Đ, Vasilijić S, Čolić M, Vučinić Ž, Rađen S, Miličić B. Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself. in Vojnosanitetski pregled. 2013;70(4):352-362.
doi:10.2298/VSP1304352S .

Stanković-Popović, Verica, Popović, Dragan, Dimković, Nada, Maksić, Đoko, Vasilijić, Saša, Čolić, Miodrag, Vučinić, Žarko, Rađen, Slavica, Miličić, Biljana, "Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself" in Vojnosanitetski pregled, 70, no. 4 (2013):352-362,
https://doi.org/10.2298/VSP1304352S . .

TY  - JOUR
AU  - Stanković-Popović, Verica
AU  - Nesić, V.
AU  - Popović, D.
AU  - Maksić, Đoko
AU  - Čolić, Miodrag
AU  - Vasilijić, Saša
AU  - Vučinić, Žarko
AU  - Miličić, Biljana
AU  - Rađen, Slavica
AU  - Dimković, Nada
PY  - 2011
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/1614
AB  - Background: Chronic inflammation, malnutrition and atherosclerosis (MIA syndrome) are important predictors of high mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. We aimed to evaluate the effects of PD solutions (standard vs. biocompatible) on some parameters of MIA syndrome in patients undergoing CAPD. Methods: 42 stable patients who were on CAPD at least 2.5 years participated in this cross-sectional study. Patients who had severe anemia (Hb  lt  10 g/l), immunomodulatory therapy, peritonitis or any inflammatory conditions for at least 3 months before the analysis, malignant disease and acute exacerbation of heart failure, were excluded. 21 (50%) patients were treated with standard PD solutions (CAPDP-1), while the remaining 21(50% of patients) were treated with biocompatible PD solutions (neutral solutions with lower level of glucose degradation products and lower concentration of calcium, CAPDP-2). All patients underwent echocardiography and B-mode ultrasonography of common carotid arteries together with assessments of nutrition status and parameters of systemic and local inflammation. Results: There were no significant differences between the groups concerning age, gender, underlying disease, residual renal function, peritoneal transport characteristics, comorbidity or therapy applied. Patients from group CAPDP-2 had a significantly lower serum level of hs-CRP (3.7 +/- 2.6 mg/l vs. 6.3 +/- 4.5 mg/l; p = 0.023) and significantly better nutritional status confirmed by mid-arm circumference (p = 0.015), mid-arm muscle circumference (p = 0.002) and subjective global assessment (14.28% of patients in CAPDP-2 vs. 71% of patients in CAPDP-1 were malnourished; p = 0.000). Group CAPD-2 had less frequent left ventricular hypertrophy (p = 0.039), thinner intima-media thickness (p = 0.005), smaller carotid narrowing (p = 0.000) and fewer calcified plaques of common carotide arteries (p = 0.003). No significant difference between the CAPDP groups was observed in serum and effluent levels of inflammatory cytokines (IL-1, IL-6 and TNF-alpha) and CA-125 effluent level. Logistic regression analysis did not confirm that biocompatibility of PD solutions was an independent predictor of any parameter of MIA syndrome. Conclusions: According to the present study and logistic regression analysis, the effect of biocompatible CAPD solutions on parameters of malnutrition, inflammation and atherosclerosis have to be confirmed by well-designed and controlled studies in a higher number of patients.
PB  - Dustri-Verlag Dr Karl Feistle, Deisenhofen-Muenchen
T2  - Clinical Nephrology
T1  - Effects of conventional versus biocompatible peritoneal dialysis solutions on peritoneal and systemic inflammation, malnutrition and atherosclerosis in CAPD patients
VL  - 76
IS  - 4
SP  - 314
EP  - 322
DO  - 10.5414/CN106991
ER  - 

@article{
author = "Stanković-Popović, Verica and Nesić, V. and Popović, D. and Maksić, Đoko and Čolić, Miodrag and Vasilijić, Saša and Vučinić, Žarko and Miličić, Biljana and Rađen, Slavica and Dimković, Nada",
year = "2011",
abstract = "Background: Chronic inflammation, malnutrition and atherosclerosis (MIA syndrome) are important predictors of high mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. We aimed to evaluate the effects of PD solutions (standard vs. biocompatible) on some parameters of MIA syndrome in patients undergoing CAPD. Methods: 42 stable patients who were on CAPD at least 2.5 years participated in this cross-sectional study. Patients who had severe anemia (Hb  lt  10 g/l), immunomodulatory therapy, peritonitis or any inflammatory conditions for at least 3 months before the analysis, malignant disease and acute exacerbation of heart failure, were excluded. 21 (50%) patients were treated with standard PD solutions (CAPDP-1), while the remaining 21(50% of patients) were treated with biocompatible PD solutions (neutral solutions with lower level of glucose degradation products and lower concentration of calcium, CAPDP-2). All patients underwent echocardiography and B-mode ultrasonography of common carotid arteries together with assessments of nutrition status and parameters of systemic and local inflammation. Results: There were no significant differences between the groups concerning age, gender, underlying disease, residual renal function, peritoneal transport characteristics, comorbidity or therapy applied. Patients from group CAPDP-2 had a significantly lower serum level of hs-CRP (3.7 +/- 2.6 mg/l vs. 6.3 +/- 4.5 mg/l; p = 0.023) and significantly better nutritional status confirmed by mid-arm circumference (p = 0.015), mid-arm muscle circumference (p = 0.002) and subjective global assessment (14.28% of patients in CAPDP-2 vs. 71% of patients in CAPDP-1 were malnourished; p = 0.000). Group CAPD-2 had less frequent left ventricular hypertrophy (p = 0.039), thinner intima-media thickness (p = 0.005), smaller carotid narrowing (p = 0.000) and fewer calcified plaques of common carotide arteries (p = 0.003). No significant difference between the CAPDP groups was observed in serum and effluent levels of inflammatory cytokines (IL-1, IL-6 and TNF-alpha) and CA-125 effluent level. Logistic regression analysis did not confirm that biocompatibility of PD solutions was an independent predictor of any parameter of MIA syndrome. Conclusions: According to the present study and logistic regression analysis, the effect of biocompatible CAPD solutions on parameters of malnutrition, inflammation and atherosclerosis have to be confirmed by well-designed and controlled studies in a higher number of patients.",
publisher = "Dustri-Verlag Dr Karl Feistle, Deisenhofen-Muenchen",
journal = "Clinical Nephrology",
title = "Effects of conventional versus biocompatible peritoneal dialysis solutions on peritoneal and systemic inflammation, malnutrition and atherosclerosis in CAPD patients",
volume = "76",
number = "4",
pages = "314-322",
doi = "10.5414/CN106991"
}

Stanković-Popović, V., Nesić, V., Popović, D., Maksić, Đ., Čolić, M., Vasilijić, S., Vučinić, Ž., Miličić, B., Rađen, S.,& Dimković, N.. (2011). Effects of conventional versus biocompatible peritoneal dialysis solutions on peritoneal and systemic inflammation, malnutrition and atherosclerosis in CAPD patients. in Clinical Nephrology
Dustri-Verlag Dr Karl Feistle, Deisenhofen-Muenchen., 76(4), 314-322.
https://doi.org/10.5414/CN106991

Stanković-Popović V, Nesić V, Popović D, Maksić Đ, Čolić M, Vasilijić S, Vučinić Ž, Miličić B, Rađen S, Dimković N. Effects of conventional versus biocompatible peritoneal dialysis solutions on peritoneal and systemic inflammation, malnutrition and atherosclerosis in CAPD patients. in Clinical Nephrology. 2011;76(4):314-322.
doi:10.5414/CN106991 .

Stanković-Popović, Verica, Nesić, V., Popović, D., Maksić, Đoko, Čolić, Miodrag, Vasilijić, Saša, Vučinić, Žarko, Miličić, Biljana, Rađen, Slavica, Dimković, Nada, "Effects of conventional versus biocompatible peritoneal dialysis solutions on peritoneal and systemic inflammation, malnutrition and atherosclerosis in CAPD patients" in Clinical Nephrology, 76, no. 4 (2011):314-322,
https://doi.org/10.5414/CN106991 . .

TY  - JOUR
AU  - Stanković-Popović, Verica
AU  - Maksić, Đoko
AU  - Vučinić, Žarko
AU  - Lepić, Toplica
AU  - Popović, Dragan
AU  - Miličić, Biljana
PY  - 2008
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/1453
AB  - Background/Aim. Peritoneal dialysis (PD) patients have an increased risk for cardiovascular diseases. The aim of the study was to evaluate the cardiovascular changes in patients undergoing chronic PD and the eventual existing differences depending on biocompatibility of dialysis solutions. Methods. After 3±2 years of starting PD, 21 PD patients on the treatment with bioincompatible dialysis solutions (conventional glucose- based solutions: PDP-1), average age 47.43±12.87 years, and 21 PD patients on the treatment with biocompatible dialysis solutions (neutral solutions with lower level of glucose degradation products, lower concentration of Ca2+ and neutral pH: PDP-2), average age 68.62±13.98 years, participated in the longitudinal study. The average number of episodes of peritonitis was similare in both groups: 1 episode per 36 months of the treatment. The control group included 21 patients with preterminal phase of chronic renal failure (Glomerular Filtration Rate: 22.19±10.73 ml/min), average age 65.29± 13.74 years. All the patients underwent transthoracal echocardiography (in order to detect: eject fraction (EF), left ventricular hypertrophy (LVH), and valvular calcification (VC) and B-mode ultrasonography of common carotid artery (CCA): IMT, lumen narrowing, and plaque detection. Results. The values of EF were: in PDP-1 group 62.05±5.65%, in PDP-2 group 53.43±7.47%, and in the control group 56.71±8.12% (Bonferroni test, p = 0.001). The recorded LVH was: in PDP-1 group in 47.6% of the patients; in PDP-2 group in 61.9% of the patients; and in control the group in 52.4% (χ2 test; p = 0.639). The detected VC was: in PDP-1 in 52.4% of the patients, in PDP-2 group in 42.9% of the patients, and in the control group in 23.8% of the patients (χ2 test; p = 0.776). The IMT was: in PDP-1 group 1.26±0.54 mm, in PDP-2 group 1.23±0.32, and in the control group 1.25±0.27 mm (Bonferroni test; p = 0.981). An average lumen narrowing was: in PDP-1 group 13.78±18.26%, in PDP-2 group 18.57±22.98%, and in the control group 25.00±28.02% (Kruskal Wallis test; p = 0.413). Calcified plaques of CCA were detected in PDP-1 group in 61.9% of the patients, in PDP-2 group in 85.7%, of the patients and in the control group in 81% of the patients (χ2 test; p = 0.159). Conclusion. Generally, PD had a significant influence on cardiovascular morbidity in the treated patients, especially on the left ventricular function and peripherial atherosclerosis. The age of the patients had more influence on acceleration of atherosclerosis than the length of dialysis or biocompatibility of dialysis solutions.
AB  - Uvod/Cilj. Bolesnici koji se leče peritoneumskom dijalizom (PD) imaju značajno povišen rizik od pojave kardiovaskularnih bolesti. Cilj rada bio je da se utvrde kardiovaskularne promene kod bolesnika na kontiniranoj ambulatnoj peritoneumskoj dijalizi (KAPD), kao i postojanje eventualnih razlika u njihovom prisustvu zavisno od biokompatibilnosti korišćenih rastvora za PD. Metode. Analitičkom studijom preseka obuhvaćena su ukupno 42 bolesnika lečena više od godinu dana putem KAPD (dijalizni staž: 3±2 godine). Pri tome, kod polovine bolesnika, prosečne starosti 47,43±12,87 godine, primenjivani su bioinkompatibilni rastvori za PD (kiseli standardni rastvori: PDB-1); kod druge polovine bolesnika prosečne starosti 68,62±13,98 god. primenjivani su biokompatibilniji rastvori za PD (neutralni rastvori sa znatno manjom koncentracijom degradacionih produkata glukoze, 1,25 mmol/l Ca2+ i 40 mmol/l laktata: PDB-2). Prosečan broj epizoda peritonitisa u obe grupe ispitanika bio je sličan: 1 epizoda na 36- 44 meseca lečenja. Kontrolnu grupu činio je 21 bolesnik u stadijumu III-IV hronične bubrežne insuficijencije (jačina glomerulske filtracije: 22,19±10,73 ml/min), prosečne starosti 65,29±13,74 godine. Svim bolesnicima urađena je transtoraksna ehosonografija i utvrđena ejekciona frakcija (EF) leve komore, postojanje hipertrofije leve komore (HLK) i kalcifikacije u zidu ili srčanim zaliscima (VK), kao i doplerehosonografija krvnih sudova vrata kojom se merena debljina intimomedijalnog kompleksa (IMK) nad a. carotis communis, stepen suženja lumena arterije i prisustvo kalcifikovanih aterosklerotskih plakova. Rezultati. Vrednosti EF bili su: kod PDB-1 62,05±5,65%; kod PDB-2 53,43±7,47%; u kontrolnoj grupi 56,71±8,12% (Bonferroni test, p = 0,001). HLK zabeležena je u PDB-1 grupi kod 47,6% bolesnika, u PDB-2 grupi kod 61,9% bolesnika i u kontrolnoj grupi kod 52,4% bolesnika (χ2 test; p = 0,639). Detektovane su VK kod 52,4% bolesnika u PDB-1 grupi kod 42,9% bolesnika u PDB-2 grupi i kod 23,8% bolesnika iz kontrolne grupe (χ2 test; p = 0,776). Debljina IMK iznosila je u PDB-1 grupi 1,26±0,54 mm, u PDB-2 grupi 1,23±0,32 mm i u kontrolnoj grupi 1,25±0,27 mm (Bonferroni test; p = 0,981). Stepen suženja lumena arterije: bio je u PDB-1 grupi 13,78±18,26%, u PDB-2 grupi 18,57±22,98% i u kontrolnoj grupi 25,00±28,02% (Kruskal Wallis test; p = 0,413). Kalcifikovani aterosklerotski plakovi detektovani su kod 61,9% bolesnika u PDB-1 grupi, kod 85,7% bolesnika u PDB-2 grupi i kod 81% bolesnika u kontrolnoj grupi (χ2 test; p = 0,159). Zaključak. PD dodatno doprinosi obolevanju kardiovaskularnog sistema kod bolesnika sa HBI, naročito preko uticaja na EF srca i perifernu aterosklerozu. Pri tome, starost bolesnika na KAPD u većoj meri utiče na ispoljavanje ubrzanog procesa ateroskleroze i kardiovaskularnog oboljenja nego dužina vremenskog dijaliziranja i biokompatibilnost korišćenih rastvora.
PB  - Vojnomedicinska akademija - Institut za naučne informacije, Beograd
T2  - Vojnosanitetski pregled
T1  - Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis
T1  - Povezanost vrste rastvora za dijalizu sa stepenom kardiovaskularnih promena kod bolesnika na kontinuiranoj ambulatnoj peritoneumskoj dijalizi
VL  - 65
IS  - 3
SP  - 221
EP  - 228
DO  - 10.2298/VSP0803221S
ER  - 

@article{
author = "Stanković-Popović, Verica and Maksić, Đoko and Vučinić, Žarko and Lepić, Toplica and Popović, Dragan and Miličić, Biljana",
year = "2008",
abstract = "Background/Aim. Peritoneal dialysis (PD) patients have an increased risk for cardiovascular diseases. The aim of the study was to evaluate the cardiovascular changes in patients undergoing chronic PD and the eventual existing differences depending on biocompatibility of dialysis solutions. Methods. After 3±2 years of starting PD, 21 PD patients on the treatment with bioincompatible dialysis solutions (conventional glucose- based solutions: PDP-1), average age 47.43±12.87 years, and 21 PD patients on the treatment with biocompatible dialysis solutions (neutral solutions with lower level of glucose degradation products, lower concentration of Ca2+ and neutral pH: PDP-2), average age 68.62±13.98 years, participated in the longitudinal study. The average number of episodes of peritonitis was similare in both groups: 1 episode per 36 months of the treatment. The control group included 21 patients with preterminal phase of chronic renal failure (Glomerular Filtration Rate: 22.19±10.73 ml/min), average age 65.29± 13.74 years. All the patients underwent transthoracal echocardiography (in order to detect: eject fraction (EF), left ventricular hypertrophy (LVH), and valvular calcification (VC) and B-mode ultrasonography of common carotid artery (CCA): IMT, lumen narrowing, and plaque detection. Results. The values of EF were: in PDP-1 group 62.05±5.65%, in PDP-2 group 53.43±7.47%, and in the control group 56.71±8.12% (Bonferroni test, p = 0.001). The recorded LVH was: in PDP-1 group in 47.6% of the patients; in PDP-2 group in 61.9% of the patients; and in control the group in 52.4% (χ2 test; p = 0.639). The detected VC was: in PDP-1 in 52.4% of the patients, in PDP-2 group in 42.9% of the patients, and in the control group in 23.8% of the patients (χ2 test; p = 0.776). The IMT was: in PDP-1 group 1.26±0.54 mm, in PDP-2 group 1.23±0.32, and in the control group 1.25±0.27 mm (Bonferroni test; p = 0.981). An average lumen narrowing was: in PDP-1 group 13.78±18.26%, in PDP-2 group 18.57±22.98%, and in the control group 25.00±28.02% (Kruskal Wallis test; p = 0.413). Calcified plaques of CCA were detected in PDP-1 group in 61.9% of the patients, in PDP-2 group in 85.7%, of the patients and in the control group in 81% of the patients (χ2 test; p = 0.159). Conclusion. Generally, PD had a significant influence on cardiovascular morbidity in the treated patients, especially on the left ventricular function and peripherial atherosclerosis. The age of the patients had more influence on acceleration of atherosclerosis than the length of dialysis or biocompatibility of dialysis solutions., Uvod/Cilj. Bolesnici koji se leče peritoneumskom dijalizom (PD) imaju značajno povišen rizik od pojave kardiovaskularnih bolesti. Cilj rada bio je da se utvrde kardiovaskularne promene kod bolesnika na kontiniranoj ambulatnoj peritoneumskoj dijalizi (KAPD), kao i postojanje eventualnih razlika u njihovom prisustvu zavisno od biokompatibilnosti korišćenih rastvora za PD. Metode. Analitičkom studijom preseka obuhvaćena su ukupno 42 bolesnika lečena više od godinu dana putem KAPD (dijalizni staž: 3±2 godine). Pri tome, kod polovine bolesnika, prosečne starosti 47,43±12,87 godine, primenjivani su bioinkompatibilni rastvori za PD (kiseli standardni rastvori: PDB-1); kod druge polovine bolesnika prosečne starosti 68,62±13,98 god. primenjivani su biokompatibilniji rastvori za PD (neutralni rastvori sa znatno manjom koncentracijom degradacionih produkata glukoze, 1,25 mmol/l Ca2+ i 40 mmol/l laktata: PDB-2). Prosečan broj epizoda peritonitisa u obe grupe ispitanika bio je sličan: 1 epizoda na 36- 44 meseca lečenja. Kontrolnu grupu činio je 21 bolesnik u stadijumu III-IV hronične bubrežne insuficijencije (jačina glomerulske filtracije: 22,19±10,73 ml/min), prosečne starosti 65,29±13,74 godine. Svim bolesnicima urađena je transtoraksna ehosonografija i utvrđena ejekciona frakcija (EF) leve komore, postojanje hipertrofije leve komore (HLK) i kalcifikacije u zidu ili srčanim zaliscima (VK), kao i doplerehosonografija krvnih sudova vrata kojom se merena debljina intimomedijalnog kompleksa (IMK) nad a. carotis communis, stepen suženja lumena arterije i prisustvo kalcifikovanih aterosklerotskih plakova. Rezultati. Vrednosti EF bili su: kod PDB-1 62,05±5,65%; kod PDB-2 53,43±7,47%; u kontrolnoj grupi 56,71±8,12% (Bonferroni test, p = 0,001). HLK zabeležena je u PDB-1 grupi kod 47,6% bolesnika, u PDB-2 grupi kod 61,9% bolesnika i u kontrolnoj grupi kod 52,4% bolesnika (χ2 test; p = 0,639). Detektovane su VK kod 52,4% bolesnika u PDB-1 grupi kod 42,9% bolesnika u PDB-2 grupi i kod 23,8% bolesnika iz kontrolne grupe (χ2 test; p = 0,776). Debljina IMK iznosila je u PDB-1 grupi 1,26±0,54 mm, u PDB-2 grupi 1,23±0,32 mm i u kontrolnoj grupi 1,25±0,27 mm (Bonferroni test; p = 0,981). Stepen suženja lumena arterije: bio je u PDB-1 grupi 13,78±18,26%, u PDB-2 grupi 18,57±22,98% i u kontrolnoj grupi 25,00±28,02% (Kruskal Wallis test; p = 0,413). Kalcifikovani aterosklerotski plakovi detektovani su kod 61,9% bolesnika u PDB-1 grupi, kod 85,7% bolesnika u PDB-2 grupi i kod 81% bolesnika u kontrolnoj grupi (χ2 test; p = 0,159). Zaključak. PD dodatno doprinosi obolevanju kardiovaskularnog sistema kod bolesnika sa HBI, naročito preko uticaja na EF srca i perifernu aterosklerozu. Pri tome, starost bolesnika na KAPD u većoj meri utiče na ispoljavanje ubrzanog procesa ateroskleroze i kardiovaskularnog oboljenja nego dužina vremenskog dijaliziranja i biokompatibilnost korišćenih rastvora.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis, Povezanost vrste rastvora za dijalizu sa stepenom kardiovaskularnih promena kod bolesnika na kontinuiranoj ambulatnoj peritoneumskoj dijalizi",
volume = "65",
number = "3",
pages = "221-228",
doi = "10.2298/VSP0803221S"
}

Stanković-Popović, V., Maksić, Đ., Vučinić, Ž., Lepić, T., Popović, D.,& Miličić, B.. (2008). Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis. in Vojnosanitetski pregled
Vojnomedicinska akademija - Institut za naučne informacije, Beograd., 65(3), 221-228.
https://doi.org/10.2298/VSP0803221S

Stanković-Popović V, Maksić Đ, Vučinić Ž, Lepić T, Popović D, Miličić B. Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis. in Vojnosanitetski pregled. 2008;65(3):221-228.
doi:10.2298/VSP0803221S .

Stanković-Popović, Verica, Maksić, Đoko, Vučinić, Žarko, Lepić, Toplica, Popović, Dragan, Miličić, Biljana, "Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis" in Vojnosanitetski pregled, 65, no. 3 (2008):221-228,
https://doi.org/10.2298/VSP0803221S . .