Evaluation of arterial stiffness between peritoneal dialysis and hemodialysis in patients with renal replacement therapy

Evaluation of arterial stiffness between peritoneal dialysis and hemodialysis in patients with renal replacement therapy

Objectives: The aortic stiffness index beta (ASI-β), calculated noninvasively with the pressure change caused by arterial strain and volume changes on echocardiography, shows a strong correlation with invasive measurements of arterial stiffness. This study aimed to compare arterial stiffness and distensibility between peritoneal dialysis (PD) and hemodialysis (HD) and patients in renal replacement therapy. Methods: This cross-sectional and observational study analyzed 108 patients under renal replacement therapy (PD and HD). The aortic stiffness index beta (ASI-β) was calculated for each group. Results: The mean age of the patients in the study was 58.2±11.1 years, and 49 (45.4%) of the patients were female and 59 (54.6%) were male. Age, gender, comorbid rates, and levels of blood pressure and heart rate did not differ between the PD and HD groups. Blood pressure levels and heart rate. Mean aortic strain (5.6±1.9 vs. 9.4±2.8, p < 0.001) and median distensibility (1.5 vs. 2.9 cm, p < 0.001) were lower in the PD group than the HD group, while median ASI-β (11.6 vs. 6.2, p < 0.001) and mean E/e’ (10.6±2.9 vs. 9.2±2.3, p = 0.006) were higher in the PD group. The rate of concentric hypertrophy was higher in the PD group (47.5% vs. 23.5%, p = 0.005). Conclusion: PD patients have higher arterial stiffness and lower distensibility levels compared to HD patients. Therefore, patients with PD may be more prone to diastolic dysfunction, cardiovascular disease, and events.


  • 1. Aoki J, Ikari Y. Cardiovascular disease in patients with end-stage renal disease on hemodialysis. Ann Vasc Dis 2017;10:327-37.
  • 2. Carracedo J, Alique M, Vida C, Bodega G, Ceprian N, Morales e, et al. Mechanisms of cardiovascular disorders in patients with chronic kidney disease: a process related to accelerated senescence. Front Cell Dev Biol 2020;8:185.
  • 3. Garnier AS, Briet M. Arterial stiffness and chronic kidney disease. Pulse (Basel) 2016;3:229-41.
  • 4. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27:2588-605.
  • 5. Olczyk P, Malyszczak A, Golebiowski T, Letachowicz K, Szymcak A, Mazanowska O, et al. Arterial stiffness assessed by oscillometric method in kidney transplant, predialysis, and dialysis patients. Transplant Proc 2020;52:2337-40.
  • 6. Kocyigit I, Sipahioglu MH, Orscelik O, Unal A, Celik A, Abbas SR, et al. The association between arterial stiffness and fluid status in peritoneal dialysis patients. Perit Dial Int 2014;34:781-90.
  • 7. Fischer EC, Zocalo Y, Galli C, Wray S, Bia D. Arterial stiffness and renal replacement therapy: a controversial topic. Int J Nephrol 2015;2015:729609.
  • 8. Cho JY, Kim KH. Evaluation of arterial stiffness by echocardiography: methodological aspects. Chonnam Med J 2016;52:101-6.
  • 9. Sipahioglu MH, Kucuk H, Unal A, Kaya MG, Oguz F, Tokgoz B, et al. Impact of arterial stiffness on adverse cardiovascular outcomes and mortality in peritoneal dialysis patients. Perit Dial Int 2012;32:73-80.
  • 10. Cheung AK, Sarnak MJ, Yan G, Berkoben M, Heyka R, Kaufman A, et al. Cardiac diseases in maintenance hemodialysis patients: results of the HEMO Study. Kidney Int 2004;65:2380-9.
  • 11. Candido JSA, Camelo LV, Mill JG, Lotufo PA, Ribeiro ALP, Duncan BB, et al. Greater aortic stiffness is associated with renal dysfunction in participants of the ELSA-Brasil cohort with and without hypertension and diabetes. PLoS One 2019;14:e0210522.
  • 12. Ganesh SK, Hulbert-Shearon T, Port FK, Eagle K, Stack AG. Mortality differences by dialysis modality among incident ESRD patients with and without coronary artery disease. J Am Soc Nephrol 2003;14:415-24.
  • 13. Stack AG, Molony DA, Rahman NS, Dosekun A, Murthy B. Impact of dialysis modality on survival of new ESRD patients with congestive heart failure in the United States. Kidney Int 2003;64:1071-9.
  • 14. Sun CY, Li CY, Sung JM, Cheng YY, Wu JL, Kuo YT, et al. A comparison of the risk of acute myocardial infarction in patients receiving hemodialysis and peritoneal dialysis: A population-based, propensity score-matched cohort study. Atherosclerosis 2020;307:130-8.
  • 15. Sigrist M, Bungay P, Taal MW, McIntyre CW. Vascular calcification and cardiovascular function in chronic kidney disease. Nephrol Dial Transplant 2006;21:707-14.
  • 16. Chung AW, Yang HH, Kim JM, Sigrist MK, Brin G, Chum E, et al. Arterial stiffness and functional properties in chronic kidney disease patients on different dialysis modalities: an exploratory study. Nephrol Dial Transplant 2010;25:4031-41.
  • 17. Strozecki P, Donderski R, Kardymowicz A, Manitius J. Comparison of arterial stiffness in end‑stage renal disease patients treated with peritoneal dialysis or hemodialysis. Pol Arch Med Wewn 2012;122:33-9.
  • 18. Covic A, Goldsmith DJ, Florea L, Gusbeth-Tatomir P, Covic M. The influence of dialytic modality on arterial stiffness, pulse wave reflections, and vasomotor function. Perit Dial Int 2004;24:365-72.
  • 19. Chang JH, Yoon SJ, Han SH, Shin SK, Jeon DW, Yang JY, et al. The impact of dialysis modality on arterial stiffness in patients with end-stage renal disease. Ren Fail 2010;32:947-53.
  • 20. Mimura T, Takenaka T, Kanno Y, Aoki H, Ohshima J, Suzuki H. Comparison of changes in pulse wave velocity in patients on continuous ambulatory peritoneal dialysis and hemodialysis one year after introduction of dialysis therapy. Adv Perit Dial 2005;21:139-45.
  • 21. Rajzer MW, Wojciechowska W, Klocek M, Palka I, Brzozowska-Kiszka M, Kawecka-Jaszcz K. Comparison of aortic pulse wave velocity measured by three techniques: Complior, SphygmoCor and Arteriograph. J Hypertens 2008;26:2001-7.
  • 22. Zapolski T, Wysokinski A, Janicka L, Grzebalska A, Ksiazek A. Aortic stiffness and valvular calcifications in patients with end-stage renal disease. Pol Arch Med Wewn 2008;118:111-8.
  • 23. Segall L, Covic A. Cardiovascular disease in haemodialysis and peritoneal dialysis: arguments pro haemodialysis. Nephrol Dial Transplant 2007;22:59-63.
  • 24. Stompor T, Rajzer M, Sulowicz W, Dembinka-Kiec A, Janda K, Kawacka-Jaszcz K, et al. Trends and dynamics of changes in aortic pulse wave velocity over one-year observation period in patients treated with peritoneal dialysis. Int J Artif Organs 2004;27:904-6.
  • 25. Jung JY, Hwang YH, Lee SW, Lee H, Kim DK, Kim S, et al. Factors associated with aortic stiffness and its change over time in peritoneal dialysis patients. Nephrol Dial Transplant 2010;25:4041-8.
  • 26. Alexandrou ME, Sarafidis P, Mu PT, Sachpekidis V, Papadopoulos C, Loutradis C, et al. Cardiac geometry, function, and remodeling patterns in patients under maintenance hemodialysis and peritoneal dialysis treatment. Ther Apher Dial 2022;26:601-12.
  • 27. Kott J, Reichek N, Butler J, Arbeit L, Mallipattu SK. Cardiac imaging in dialysis patients. Kidney Med 2020;2:629-38.
  • 28. Toprak A, Reddy J, Chen W, Srinivasan S, Berenson G. Relation of pulse pressure and arterial stiffness to concentric left ventricular hypertrophy in young men (from the Bogalusa Heart Study). Am J Cardiol 2009;103:978-84.
  • 29. Di Lullo L, Gorini A, Russo D, Santoboni A, Ronco C. Left ventricular hypertrophy in chronic kidney disease patients: from pathophysiology to treatment. Cardiorenal Med 2015;5:254-66.
  • 30. Tangwonglert T, Davenport A. Changes in extracellular water and left ventricular mass in peritoneal dialysis patients. Kidney Res Clin Pract 2021;40:135-42.
  • 31. Covic A, Gusbeth-Tatomir P, Goldsmith DJ. Arterial stiffness in renal patients: an update. Am J Kidney Dis 2005;45:965-77.


AMA Günay T. , Topal D. , Akgür S. Evaluation of arterial stiffness between peritoneal dialysis and hemodialysis in patients with renal replacement therapy. Eur Res J. 2023; 9(5): 1040-1047.
The European Research Journal
  • ISSN: 2149-3189
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2015


Sayıdaki Diğer Makaleler

Hidden face of chronic obstructive pulmonary disease: effects of patients’ psychiatric symptoms on caregivers’ burden and quality of life

Zeynep KARAGÜN, Deniz ÇELİK, Mehmet Sinan AYDIN, İbrahim GÜNDOĞMUŞ, Yusuf Tuğrul ŞİPİT

The effect of adenoidectomy on pulmonary function in children: prospective controlled study


The effect of perceived parental attitude score on symptoms of bipolar disorder and schizophrenia


Evaluation of the success of shock index and its derivatives in determining mortality in STEMI cases applied to emergency department

Guner YURTSEVER, Adem ÇAKIR, Ejder Saylav BORA

Epicardial adipose and pre-sternal subcutaneous tissues associated with extent of pneumonia and hospitalization in COVID-19


Evaluation of arterial stiffness between peritoneal dialysis and hemodialysis in patients with renal replacement therapy

Tufan GÜNAY, Dursun TOPAL, Suat AKGÜR

Evaluation of intraductal papillary mucinous neoplasms detected incidentally with magnetic resonance cholangiopancreatography

Mustafa Orhan NALBANT

Comparison of L452R mutation variant diagnosis in SARS-COV-2 PCR positive samples with two different qPCR kits


Predictive role of ABCD2, ABCD3I, C-reactive protein, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammation index in 90-day and long-term stroke after transient ischemic attack


Prognostic value of the leuko-glycemic index in coronary chronic total occlusion patients

Tezcan PEKER, Mehmet ÖZBEK, Bedrettin BOYRAZ, Selen Filiz ASLAN, Muhammed DEMİR, Burhan ASLAN