Comparison of Hemodialysis Patients With Continuous Ambulatory Peritoneal Dialysis Patients in Terms of Cardiovascular Disease Risk Factors: A Three-Year Follow-up

End stage renal disease (ESRD) is known to be associated with well known risk factors of cardiovascular disease (CVD) like hypertension and dyslipidemia. The aim of this study is to compare 2 groups of ESRD patients, who are being followed by hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) for at least 3 years, in terms of CVD risk factors, retrospectively. Totally 133 ESRD patients (Group I: 65 CAPD patients, Group II: 68 HD patients) who were followed for at least 3 years under the initial dialysis modality were included. The predialysis 3 months' laboratory (Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, LDL/HDL, albumin and C-reactive protein) and clinical findings (body weight, blood pressure, antihypertensive and antilipemic medication) of the patients were collected. The 1-12th and 25-36th months' laboratory and clinical findings were also recorded as the “first year” and “third year” follow-up results respectively. Groups were statistically comparable in terms of predialysis data. When the first year data of each group was compared according to the initial ones, total cholesterol significantly increased in Group I (p<0.01), albumin increased (p<0.0001), triglyceride increased (p<0.05) and HDL-cholesterol decreased (p<0.01) in Group II. Comparison of third year data of each group with initial ones revealed that HDL-cholesterol decreased in both groups (p<0.005, <0.0001 respectively) but also LDL-cholesterol decreased (p<0.01) in Group II. When the 1st year laboratory results of groups were compared, CAPD was found to be associated with relatively higher total cholesterol (p<0.01) and lower albumin (p<0.0001) levels. Blood pressure measurements were also higher in CAPD group (For both systolic and diastolic blood pressures p<0.001) in the 1st year. Third year data revealed that CAPD was associated with relatively higher levels of LDL-cholesterol (p<0.05) and lower levels of albumin (p<0.01) but there was no other statistical difference between groups, in terms of other lipid parameters, CRP, blood pressure and medication received. Conclusion: CAPD treatment is found to be associated with dyslipidemia and hypertension when compared to HD, especially in the first year follow- up period. This difference seems to continue in a lesser extend in the following years. CAPD patients are under persistent risk of hypoalbuminemia which may be secondary to hemodilution, peritoneal protein loss or protein malnutrition secondary to dextrose absorbtion from dialysis fluid.