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논문분류	춘계학술대회 초록집
제목	Endothelial Dysfunction Assessed by Flow-mediated Dilation is associated with Major Adverse Cardiovascular Events in Peritoneal Dialysis Patients
저자	Kyoung Sook Park, Mi Jung Lee, Yung Ly Kim, Han Jak Ryu, Young Eun Kwon,Chang-Yun Yoon, Jung Eun Lee, Hyung Jung Oh, Jung Tak Park,Hoon Young Choi, Seung Hyeok Han, Shin-Wook Kang, Tae-Hyun Yoo
출판정보	2014; 2014(1):
키워드	심혈관 부작용, 복막투석, 혈류매개 혈관확장반응
초록	Background: Endothelial dysfunction is implicated in increased cardiovascular risk in the non-dialyzed population. Although patients on dialysis are at a great risk of cardiovascular disease, the prognostic impact of endothelial dysfunction on cardiovascular outcome has not been fully investigated in these patients. Methods: We prospectively determined endothelial function by brachial artery endothelium-dependent vasodilation (flow-mediated dilation; FMD) in 143 non-diabetic peritoneal dialysis (PD) patients and 32 controls. Primary outcome was major adverse cardiac and cerebrovascular events (MACCEs). Results. Brachial FMD was significantly lower in PD patients than in controls [2.9 (1.3-4.7)% vs. 6.2 (5.4-8.3)%, p< 0.001]. During a mean follow-up of 42 months, primary outcome was observed in 25 patients (17.5%). When patients were dichotomized by the median value of FMD (2.9%), incidence rates of MACCEs were significantly higher in the group with lower FMD compared to higher FMD (7.2 vs. 3.0 per 100 person-years, p=0.03). In multivariate Cox analysis, low FMD (≤2.9%) was a significant independent predictor of MACCEs (hazard ratio=2.73, 95% confidence interval: 1.03-7.22, p=0.04). Furthermore, multivariate fractional polynomial analysis showed that the risk of MACCE decreased steadily with higher FMD values. Conclusions: Impaired brachial FMD was a significant independent predictor of MACCEs in PD patients. Estimating endothelial dysfunction by brachial FMD could be useful for stratifying cardiovascular risk in these patients.
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