Cardiovascular Risk Factors and Physical Activity in Chronic Kidney Patients on Peritoneal Dialysis

Assessment of Physical Activity Level

Physical activity is defined as any body movement that results in the body expending more energy than its basal level of energy expenditure, due to skeletal muscle contraction. The assessment of physical activity levels will be conducted using the SenseWear Armband (SWK). The SWK will be used to obtain several pieces of information, including the number of steps, total energy expenditure (in calories), average day and night sleep time (in minutes), average day and night reaching time (in minutes), average metabolic equivalent (MET), active energy expenditure (in calories) consumed during moderate (3 MET) physical activity, and physical activity duration (in minutes, 3 MET). Subjects will be requested to utilize the device for a period of seven consecutive days.

Arterial Stiffness Measurement

Arterial stiffness represents the viscoelastic properties of the vessel wall, indicates vascular damage, and is a measure of the degree of atherosclerosis. Increased arterial stiffness or decreased compliance indicates diffuse atherosclerotic involvement of the vasculature. One of the non-invasive techniques used to assess arterial stiffness is pulse wave analysis (PWA). PWA examines the pressure waveforms in the major arteries. Pulse wave velocity (PWV) and amplification index (Alx) are indices of arterial stiffness.PWV is the velocity of the pulse propagating along the arterial segment. Alx is the ratio of the difference between the late systolic pressure reflected from the periphery and the early systolic pressure to the pulse pressure and is expressed as a percentage. The IEM Mobil-O-Graph® device is used to assess arterial stiffness.

Assessment of Cardiovascular Risk Factors

The following health metrics will be evaluated using the HeartScore scoring system to determine risk percentage: heart rate, blood pressure, waist circumference, body mass index, lipid profile (total cholesterol level, LDL and HDL cholesterol, triglycerides), fasting glucose value, HbA1C value, hemoglobin, CRP, proteinuria, smoking history, and glomerular filtration rate (GFR).The HeartScore system is a web-based risk prediction and management program that aims to support clinicians in optimizing individual cardiovascular risk reduction. The HeartScore web-based program utilizes a sophisticated algorithm to calculate the 10-year cardiovascular mortality risk based on age, gender, smoking habits, blood pressure, blood cholesterol, and the total cholesterol/HDL ratio. The European (High and Low) and National versions are currently available. However, the program is designed by national cardiology associations to be adapted to the local conditions of the countries.