Cross-Sectional Associations of Visfatin and YKL-40 With Carotid Intima-Media Thickness in Peritoneal Dialysis: A 12-Month Prospective Cohort Study.

BACKGROUND: Cardiovascular disease is the leading cause of mortality in peritoneal dialysis (PD) patients. We investigated the cross-sectional and longitudinal associations of visfatin, YKL-40, and adiponectin with carotid intima-media thickness (CIMT) over 12 months. METHODS: In this 12-month prospective cohort study, 30 maintenance PD patients underwent serial serum biomarker assessment and bilateral CIMT measurement. Associations were evaluated using paired comparisons and correlation analyses. RESULTS: Both right and left CIMT increased significantly over 12 months (p < 0.01). Visfatin increased, adiponectin decreased (both p < 0.001), whereas YKL-40 remained stable. Visfatin and YKL-40 showed significant positive correlations with CIMT, while adiponectin showed negative correlations. A strong positive visfatin-YKL-40 inter-correlation was observed (r = 0.659, p < 0.001), representing a novel finding, to our knowledge, in a dialysis population. CONCLUSIONS: CIMT increased significantly over 12 months in PD patients. Visfatin and YKL-40 showed consistent positive cross-sectional associations with CIMT, whereas adiponectin showed inverse associations and declined over time. Longitudinal biomarker-CIMT associations were limited, with baseline YKL-40 being the only biomarker associated with right-sided ΔCIMT. These exploratory findings suggest potential inflammatory pathways involved in vascular remodeling in PD and warrant validation in larger prospective studies.