Longitudinal Trend in Lipid Profile of Incident Peritoneal Dialysis Patients is Not Influenced by the Use of Biocompatible Solutions

Yeoungjee Cho; Janine Büchel; Sonja Steppan; Jutta Passlick-Deetjen; Carmel M Hawley; Goce Dimeski; Margaret Clarke; David W Johnson; balANZ Trial Investigators

doi:10.3747/pdi.2014.00291

Longitudinal Trend in Lipid Profile of Incident Peritoneal Dialysis Patients is Not Influenced by the Use of Biocompatible Solutions

Perit Dial Int. 2016 Mar-Apr;36(2):146-53. doi: 10.3747/pdi.2014.00291. Epub 2015 Oct 1.

Authors

Yeoungjee Cho¹, Janine Büchel², Sonja Steppan², Jutta Passlick-Deetjen³, Carmel M Hawley¹, Goce Dimeski⁴, Margaret Clarke⁵, David W Johnson⁶; balANZ Trial Investigators

Affiliations

¹ Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia School of Medicine, University of Queensland, Brisbane, Australia Translational Research Institute, Brisbane, Australia.
² Fresenius Medical Care Deutschland, Bad Homburg, Germany.
³ Department of Nephrology, University Clinic, Duesseldorf, Germany.
⁴ School of Medicine, University of Queensland, Brisbane, Australia Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital, Brisbane, Australia.
⁵ Fresenius Medical Care, Sydney, Australia.
⁶ Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia School of Medicine, University of Queensland, Brisbane, Australia Translational Research Institute, Brisbane, Australia david.johnson2@health.qld.gov.au.

Abstract

♦

Background: The longitudinal trends of lipid parameters and the impact of biocompatible peritoneal dialysis (PD) solutions on these levels remain to be fully defined. The present study aimed to a) evaluate the influence of neutral pH, low glucose degradation product (GDP) PD solutions on serum lipid parameters, and b) explore the capacity of lipid parameters (total cholesterol [TC], triglyceride [TG], high density lipoprotein [HDL], TC/HDL, low density lipoprotein [LDL], very low density lipoprotein [VLDL]) to predict cardiovascular events (CVE) and mortality in PD patients. ♦

Methods: The study included 175 incident participants from the balANZ trial with at least 1 stored serum sample. A composite CVE score was used as a primary clinical outcome measure. Multilevel linear regression and Poisson regression models were fitted to describe the trend of lipid parameters over time and its ability to predict composite CVE, respectively. ♦

Results: Small but statistically significant increases in serum TG (coefficient 0.006, p < 0.001), TC/HDL (coefficient 0.004, p = 0.001), and VLDL cholesterol (coefficient 0.005, p = 0.001) levels and a decrease in the serum HDL cholesterol levels (coefficient -0.004, p = 0.009) were observed with longer time on PD, whilst the type of PD solution (biocompatible vs standard) received had no significant effect on these levels. Peritoneal dialysis glucose exposure was significantly associated with trends in TG, TC/HDL, HDL and VLDL levels. Baseline lipid parameter levels were not predictive of composite CVEs or all-cause mortality. ♦

Conclusion: Serum TG, TC/HDL, and VLDL levels increased and the serum HDL levels decreased with increasing PD duration. None of the lipid parameters were significantly modified by biocompatible PD solution use over the time period studied or predictive of composite CVE or mortality.

Keywords: Biocompatible; cardiovascular events; glucose degradation products; lipid; mortality; peritoneal dialysis.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biocompatible Materials / therapeutic use
Cardiovascular Diseases / prevention & control
Dialysis Solutions / therapeutic use*
Female
Glucose / metabolism
Humans
Hydrogen-Ion Concentration
Lipids / blood*
Longitudinal Studies
Male
Middle Aged
Peritoneal Dialysis*
Regression Analysis
Renal Insufficiency, Chronic / therapy*

Substances

Biocompatible Materials
Dialysis Solutions
Lipids
Glucose