Atherosclerosis and cardiovascular risk factors in CAPD

Cardiovascular disease (CVD) is the main cause of death in patients requiring renal replacement therapy. Sudden cardiac death, coronary artery disease, stroke, and peripheral vascular disease are common, and cardiac arrest and arrhythmia are the most common causes of CV death in this population. Despite major technologic improvements in dialysis therapies and small-solute clearances, chronic kidney disease (CKD) patients show a CVD death rate that is 5–25 times higher than that seen in the general population. In addition to traditional risk factors (such as age, sex, hypertension, diabete, smoking), there are several not traditional risk factors (inflammation, oxidative stress) which contribute per se to kidney disease and cardiovascular progression. Moreover, several factors associated with PD therapy may exacerbate this clinical condition (altered lipid profile, hyperinsulinemia, and formation of advanced glycation end-products) and cardiovascular risk. Therefore it is important to manage all these comorbidities and risk factors in order to reduce CVD risk in this patient population