Serum nitric oxide level and carotid arteries atherosclerosis in peritoneal dialysis patients

Objectives: Atherosclerosis is a significant cause of morbidity and mortality in peritoneal dialysis patients. The aim of this study was to measure the intima-media thickness (IMT) and peak systolic velocity (PSV) values on common carotid arteries (CCA) and to assess relationship between CCA parameters and serum nitric oxide (NO) level, traditional and uremic specific risk factors in patients treated with continuous ambulatory peritoneal dialysis (CAPD) with and without type 2 diabetes mellitus (DM2). Methods: Study included 38 patients on CAPD, (mean age 51.32 } 18.03 y) (44.7% DM2 and 55.3% non-DM2 patients). CCAIMT and PSV were determined by B-mode ultrasound and serum NO level was measured by ELISA. Results: Serum NO level in DM2 patients was significantly higher compared to non-DM2 patients (7.09 vs. 5.15 μmol/L). Vascular calcification was found in 94.1% DM2 patients and in 33.3% non-DM2 patients. There were no CCA hemodynamic flow blockages in 11.8% DM2 patients. Mid-significant hemodynamic blockage was present in 47.1% and very significant in 41.2% DM2 patients. Significant correlation was found between serum NO level and age (r=0.63), diabetes (r=0.74), IMT value (r=0.72) and number of atherosclerotic plaques (r=0.78). There was an independent association between serum NO and low-density lipoprotein level (β=3.09;p=0.04). Conclusion: Our results suggest significant association between serum NO level and morphological and functional changes of CCA in uremic patients on peritoneal dialysis, especially in patients with type 2 DM. Key words: peritoneal dialysis, nitric oxide, intima media thickness, common carotid artery, atherosclerosis, diabetes mellitus type 2