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A comparative analysis of ambulatory BP profile and arterial stiffness between CAPD and APD

Journal of Human Hypertension volume 36, pages 254–262 (2022)Cite this article

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Abstract

Prior studies have associated automated peritoneal dialysis (APD) with less effective volume and blood pressure (BP) control as compared with continuous ambulatory peritoneal dialysis (CAPD). Our study aimed to compare the volume status, ambulatory BP profile and severity of arterial stiffness between patients treated with CAPD versus APD. In a case-control design, 28 CAPD patients were matched in 1:1 ratio with 28 controls receiving APD for age, gender and diabetic status. Body composition was assessed with the method of bioimpendence spectroscopy. Twenty-four hours ambulatory BP monitoring with the Mobil-O-Graph device (IEM, Germany) was performed to determine peripheral and central hemodynamic parameters, heart rate-adjusted augmentation index (AIx75) and pulse wave velocity (PWV). Standardized office BP, antihypertensive medication use and extracellular-to-total body water ratio did not differ between CAPD and APD groups. Twenty-four hours brachial systolic BP (129.0 ± 17.3 vs. 128.1 ± 14.2 mmHg, P = 0.83) and 24-h aortic systolic BP (116.9 ± 16.4 vs. 116.4 ± 11.6 mmHg, P = 0.87) were similar in patients treated with CAPD versus APD. Similarly, there was no significant difference between PD modalities in severity of arterial stiffness, as assessed with 24-h AIx75 (24.8 ± 8.9 vs. 22.5 ± 9.1, P = 0.36) and 24-h PWV (9.1 ± 2.4 vs. 8.8 ± 2.1 m/s, P = 0.61). The present study suggests that there is no difference in peripheral and central hemodynamic parameters as well as in the severity of arterial stiffness between CAPD and APD. However, these observations should be interpreted within the context of clinical characteristics of patients included in this case-control study. The comparative effectiveness of these 2 PD modalities warrants further investigation in larger longitudinal studies.

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Fig. 1: Study flow diagram of patient enrollment.
Fig. 2: Trajectoties of hemodynamic and arterial stiffness parameters over the 24-hour ambulatory recording in the CAPD and APD groups.

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Authors and Affiliations

  1. Peritoneal Dialysis Unit, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Vasilios Vaios, Panagiotis I. Georgianos, Georgia Vareta, Pantelis E. Zebekakis & Vassilios Liakopoulos

  2. Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece

    Evangelia Dounousi

  3. Department of Nephrology, School of Medicine, University of Thessaly, Larissa, Greece

    Theodoros Eleftheriadis

  4. Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Aikaterini Papagianni

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  1. Vasilios Vaios
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Correspondence to Vassilios Liakopoulos.

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Vaios, V., Georgianos, P.I., Vareta, G. et al. A comparative analysis of ambulatory BP profile and arterial stiffness between CAPD and APD. J Hum Hypertens 36, 254–262 (2022). https://doi.org/10.1038/s41371-021-00516-5

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