Association between hyperhydration and coronary artery calcium score in patients on peritoneal dialysis

• Grant number: 24/00203-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2024
• End date: March 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Silméia Garcia Zanati Bazan
• Grantee: Igor Fachini Orive
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Introduction: Cardiovascular disease is the main cause of death in patients on peritoneal dialysis. The assessment of coronary calcification by the coronary artery calcium score (CAC) has been shown to predict the incidence of acute myocardial infarction and death from cardiovascular disease in these patients. Overhydration leads to hypertension, left ventricular hypertrophy and increased levels of natriuretic peptides, which are markers of a worse cardiovascular prognosis. In patients with non-dialysis chronic kidney disease (CKD) at all stages, overhydration was associated with coronary calcification, independent of other risk factors. This study aims to evaluate whether excess extracellular fluid could also be a risk stratifier for coronary artery disease in patients on peritoneal dialysis. Objective: To evaluate the association between overhydration and coronary artery calcium score. Methods: Cross-sectional, prospective and single-center study. Prevalent adult patients with PD will be included in the Dialysis Unit of the Hospital das Clínicas of the Faculty of Medicine of Botucatu - UNESP. The following will be carried out: collection of demographic, clinical and laboratory data; assessment of nutritional and hydration status using anthropometry and bioimpedance; calculation of residual renal function and dialysis adequacy (Kt/V); Doppler-echocardiogram, carotid ultrasound, pulse wave velocity (PWV), ankle-brachial index (ABI) and CAC. Patients will be divided into two groups, according to the result of the hyperhydration index (OH) and the CAC. Comparisons between groups will be performed using the Chi-square, Student's t or Mann-Whitney test and uni and multivariate logistic regression. The SPSS version 23 program will be used and the significance level adopted will be p <0.05. Expected results: As an outcome, we hope to find a positive association between hyperhydration and the calcium score of the coronary arteries in CKD patients undergoing peritoneal dialysis.