Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients

Background. Cardiovascular disease is the main cause of mortality in end-stage renal disease (ESRD) patients. Recent studies have indicated that non-traditional risk factors such as endothelial dysfunction (ED), chronic inflammation and protein-energy wasting (PEW) may contribute significantly to the increased cardiovascular mortality among dialysis patients. To further ascertain this association, we carried out a cross-sectional assessment of nutritional status, inflammatory markers and endothelial dysfunction in peritoneal dialysis (PD) patients. Methods. We measured ED functionally by flow-mediated vasodilatation (FMD) using doppler ultrasonography and biochemically by soluble intercellular adhesion molecule-1 (sICAM-1) in 105 stable PD patients and 32 age- and sex-matched healthy controls. We also simultaneously measured inflammatory markers and performed a subjective global assessment (SGA) of their nutritional status using a seven-point scoring scale. Subjects were subgrouped according to their nutritional and inflammatory status. Results. In PD patients, FMD was markedly lower (9.9 ± 4.8% vs. 16.4 ± 4.8%, P