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Abstract: SA-PO959

Markers of Oxidative Stress, Inflammation, and Endothelial Dysfunction in Diabetic and Non-Diabetic CKD Patients on Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Sameera, Sai Nannapaneni, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
  • Yalamanchili, Venkata A., Dallas Nephrology Associates, DeSoto, Texas, United States
  • Y, Lakshmi A., Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
  • Devi, Harini Nimmanapalli, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
  • Reddy, Sunnesh, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
  • Vishnubotla, Siva Kumar, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
  • Rapur, Ram, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
Background


Oxidative stress, inflammation and endothelial dysfunction represents the key triad for development and progression of atherosclerosis. In this study we assessed the markers of oxidative stress, inflammation and endothelial dysfunction in diabetic and non-diabetic chronic kidney disease (CKD) patients on peritoneal dialysis (PD).

Methods

This is a Cross-sectional study in 100 patients on PD among which 52 patients were non-diabetic and 48 diabetic. Blood samples were measured for oxidative stress markers- Malondialdehyde (MDA), Ferric Reducing Ability of Plasma (FRAP), Inflammatory markers - Interleukin-6, hsC-Reactive Protein (hs CRP), Fibrinogen and markers of endothelial dysfunction-Nitric Oxide (NO). Carotid Intimal Medial Thickness (CIMT) and number of plaques was measured by imaging studies. Comparisons between the two groups for continuous variables were assessed with the Student’s unpaired t-test and for categorical variables with χ2-test.

Results

MDA is found to be elevated in both group of patients on PD though there was no significant difference (p- 0.279). FRAP was decreased in both diabetic and non-diabetic patients on PD (p- 0.850). The markers of inflammation-interleukin 6, hs CRP were found to be significantly higher in diabetics when compared to non-diabetics (p- 0.001). Serum fibrinogen was found to be elevated in diabetic compared to non-diabetics though not significant (p- 0.181). The markers of endothelial dysfunction- nitric oxide, carotid intimal medial thickness, lipid profile and atherogenic indices was found to be significantly higher in diabetics compared to non-diabetics (p- 0.001). The number of plaques found were significantly higher in diabetic compared to non-diabetics (p- 0.05).

Conclusion

Our study showed presence of increased markers of inflammation and endothelial dysfunction in diabetics compared to non diabetic CKD patients on PD. Markers for oxidative stress were found to be elevated in both subset of patients on PD. These findings will have clinical implications regarding the progression of atherosclerosis in diabetic compared to non-diabetic CKD patients on PD and need to be reconfirmed in a larger sample size.