Hong Kong Med J 2007;13(Suppl 2):S33-6
Epidemiology of cardiovascular problems in Chinese continuous ambulatory peritoneal dialysis patients: prevalence, severity, and risk factors
AYM Wang, JE Sanderson, KW Chan, SF Lui
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
1. Chinese end-stage renal disease patients on continuous ambulatory peritoneal dialysis (CAPD) show a high prevalence of cardiovascular diseases (CVD) including: left ventricular hypertrophy (95%) and dilatation (92%), left ventricular systolic (35%) and diastolic dysfunction (79%), congestive heart failure (39%), coronary artery disease (23.5%), and cardiac valve calcifications (24%).
2. Apart from traditional risk factors such as age, sex, diabetes, systolic hypertension, and anaemia, there are risk factors unique to CAPD patients that increase CVD incidence and predispose to mortality and cardiovascular death. These include: loss of residual renal function, increased calcium-phosphorus product, low diastolic blood pressure, and cardiac valve calcification.
3. A more proactive approach should be adopted to prevent cardiovascular complications and improve cardiovascular health of Chinese chronic renal failure and dialysis patients. All chronic kidney disease patients, especially those with a history of heart failure, should undergo echocardiography to identify early left ventricular hypertrophy or dysfunction, or valvular calcification with a view to more aggressive intervention.