Comparison of hyperechoic lesions of the aortic valves on echocardiography between hemodialysis and CAPD patients

Abstract

Cardiovascular disorder is considered the most important risk factor in patients on hemodialysis (HD). Lipid abnormalities may be involved in the rapid development of cardiovascular disorder in dialysis patients, especially those on continuous ambulatory peritoneal dialysis (CAPD).
Hyperechoic lesions of the aortic valves on the short axis view obtained by echocardiography are regarded as a marker of atherosclerotic change. We compared 17 HD patients and 16 CAPD patients with respect to hyperechoic lesions of the aortic valves on echocardiography, serum Ca and P levels and serum lipid levels to evaluate the level of coronary atherosclerosis. The mean age of HD patients was 48.1±7.6 years and that of CAPD patients was 40.7±10.4 years. The duration of dialysis was 153.9±69 months for HD patients and 49.5±40.8 months for CAPD patients. Hyperechoic lesions of the aortic valves were found significantly more frequently (p<0.05) in CAPD patients than in HD patients (87.5% vs 58.5%), although dialysis lasted for a significantly shorter (p<0.05) period in CAPD patients than in HD patients. Serum levels of Ca, P, total cholesterol, HDL cholesterol, LDL cholesterol and Lp(a) were not significantly different between HD and CAPD patients. Serum levels of triglyceride (TG) and β-lipoprotein were significantly higher (p<0.01) in CAPD patients than in HD patients (TG: HD patients 109.4±8.9mg/dl; CAPD patients 186.1±113.1mg/dl; β-lipoprotein: HD patients 206.8±105.1mg/dl, CARD patients 463.5±160.3mg/dl). These results suggest that coronary atherosclerosis may occur more frequently in CAPD patients than in HD patients and that elevated levels of TG and β-lipoprotein in serum are probably related to the development of coronary atherosclerosis in CAPD patients.