Angiotensin II receptor antagonists supplementation is associated with arterial stiffness: Insight from a retrospective study in 116 peritoneal dialysis patients

Background. Brachial-ankle pulse wave velocity (baPWV), a non-invasive waveform analysis, is a useful tool for the vascular evaluation of arterial stiffness. Increased baPWV values have been found increased in patients with arterial stiffness. The aim of this study was to investigate retrospectively the association between arterial stiffness and the common medications used in peritoneal dialysis patients. Methods. In all, 116 peritoneal dialysis patients (35 males and 81 females) received peritoneal dialysis for more than four months. Patients who had dialysis-related peritonitis or other infection within six months prior to this study, inflammation disease, fasting serum sugar ≥126 mg/dL, and/or use of oral hypoglycemic agents or insulin injections were excluded. The medications that were enrolled in our study were calcium-containing phosphate binders, vitamin-B complex, folic acid, and antihypertensive medications. baPWV was determined using an automated, non-invasive, waveform analysis device. Results. In a step-wise multiple linear regression analysis, baPWV correlated independently with systolic blood pressure (t = 8.4, p < 0.001) and age (t = 5.5, p < 0.001), and inversely correlated with body mass index (t = -3.19, p = 0.002) and the use of angiotensin II receptor antagonists (t = -2.35, p = 0.021). Conclusion. In this retrospective study of peritoneal dialysis patients, we found that angiotensin II receptor antagonists (ARBs) in peritoneal dialysis patients may be an independent factor for arterial stiffness. Hence, we suggest that compared with other antihypertensive drugs, ARBs may be a good choice for lowering arterial stiffness in PD patients. However, further studies on the optimal treatment of arterial stiffness in peritoneal dialysis patients are warranted.