Arterial stiffness evaluated by carotid-femoral pulse wave velocity increases the risk of chronic kidney disease in a Chinese population-based cohort

Abstract Metabolic acidosis is common in chronic kidney disease (CKD) and may have various deleterious consequences. Arterial stiffness in CKD patients is associated with poor cardiovascular outcomes. The present study aimed to evaluate the association between serum bicarbonate and arterial stiffness using the baseline cross-sectional data set of a large-scale Korean CKD cohort. 2,238 CKD patients were enrolled in the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) from 2011 to 2016. The present study was conducted on 1,659 patients included in this cohort with baseline serum bicarbonate and brachial-to-ankle pulse wave velocity (baPWV) data. Metabolic acidosis was defined as a serum bicarbonate level of <22 mmol/L, and baPWV was used as a surrogate of arterial stiffness. Mean serum bicarbonate was 25.8 ± 3.6 mmol/L. 210 (12.7%) patients had metabolic acidosis. baPWV was significantly higher in patients with metabolic acidosis (P < 0.001) and showed a significant inverse correlation with serum bicarbonate (Unstandardized β −16.0 cm/sec; 95% CI −20.5, −11.4; P < 0.001) in an unadjusted model, which was retained after adjustment (Unstandardized β −5.4 cm/sec; 95% CI −9.9, −1.0; P = 0.017). Metabolic acidosis was found to be associated with a high baPWV in pre-dialysis CKD patients.

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MO147ASSOCIATION OF CHA2DS2-VASC SCORE WITH CAROTID-FEMORAL PULSE WAVE VELOCITY IN CHRONIC KIDNEY DISEASE PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab092.0025 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Nina Vodošek Hojs ◽

Robert Ekart ◽

Sebastjan Bevc ◽

Nejc Piko ◽

Radovan Hojs

Keyword(s):

Chronic Kidney Disease ◽

Regression Analysis ◽

Kidney Disease ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

Wave Velocity ◽

Pulse Wave ◽

Group 2

Abstract Background and Aims Chronic kidney disease (CKD) patients suffer from high cardiovascular morbidity and mortality. Arterial stiffness is an important parameter for the evaluation of cardiovascular risk. Carotid-femoral pulse wave velocity (cfPWV) is the gold standard measure for the assessment of arterial stiffness. CHA2DS2-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF). However, it is also useful in predicting outcome in different cardiovascular conditions, independent of the presence of AF. Therefore, the aim of our research was to assess the association of CHA2DS2-VASc score with cfPWV in CKD patients. Method Eighty-seven non-dialysis CKD patients from our outpatient clinic were included. At the time of inclusion, medical history data and standard blood results were collected, CHA2DS2-VASc score was calculated, cfPWV measurements (SphygmoCor System) were done. Correlation between CHA2DS2-VASc score and cfPWV was assessed. Multiple regression analysis with cfPWV as dependent and CHA2DS2-VASc score, eGFR, urinary albumin/creatinine, haemoglobin, high sensitivity CRP, serum calcium, phosphate and intact PTH as independent variables was performed. Additionally, patients were divided into two groups according to median value of CHA2DS2-VASc score (group 1: CHA2DS2-VASc score ≤2, group 2: CHA2DS2-VASc score >2). Data of both groups were compared by t-test or Mann-Whitney test. Results CHA2DS2-VASc score correlated with cfPWV (r=0.380, p=0.001). In multiple regression analysis only CHA2DS2-VASc score was significantly associated with cfPWV (p=0.001). Data of both groups of patients divided according to median value of CHA2DS2-VASc score are presented in table 1. cfPWV was significantly higher in group 2 (13.40±3.50 vs 10.46±2.93, p=0.001). Groups of patients also differed significantly in age, presence of diabetes, eGFR and serum phosphate. Conclusion CHA2DS2-VASc score is associated with cfPWV in CKD patients. Patients with a higher CHA2DS2-VASc score have stiffer arteries.

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Chronic Kidney Disease and Pulse Wave Velocity: A Narrative Review

International Journal of Hypertension ◽

10.1155/2019/9189362 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 12

Author(s):

Nicole Lioufas ◽

Carmel M. Hawley ◽

James D. Cameron ◽

Nigel D. Toussaint

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Cardiovascular Mortality ◽

Aortic Stiffness ◽

Pulse Wave

Chronic kidney disease (CKD) is associated with excess cardiovascular mortality, resulting from both traditional and nontraditional, CKD-specific, cardiovascular risk factors. Nontraditional risk factors include the entity Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) which is characterised by disorders of bone and mineral metabolism, including biochemical abnormalities of hyperphosphatemia and hyperparathyroidism, renal osteodystrophy, and vascular calcification. Increased arterial stiffness in the CKD population can be attributed amongst other influences to progression of vascular calcification, with significant resultant contribution to the cardiovascular disease burden. Pulse wave velocity (PWV) measured over the carotid-femoral arterial segments is the noninvasive gold-standard technique for measurement of aortic stiffness and has been suggested as a surrogate cardiovascular end-point. A PWV value of 10 m/s or greater has been recommended as a suitable cut-off for an increased risk of cardiovascular mortality. CKD is a risk factor for an excessive rate of increase in aortic stiffness, reflected by increases in PWV, and increased aortic PWV in CKD shows faster progression than for individuals with normal kidney function. Patients with varying stages of CKD, as well as those on dialysis or with a kidney transplant, have different biological milieu which influence aortic stiffness and associated changes in PWV. This review discusses the pathophysiology of arterial stiffness with CKD and outlines the literature on PWV across the spectrum of CKD, highlighting that determination of arterial stiffness using aortic PWV can be a useful diagnostic and prognostic tool for assessing cardiovascular disease in the CKD population.

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The association between Hba1c and arterial stiffness among non-diabetic patients with chronic kidney disease

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.200245 ◽

2021 ◽

Vol 20 ◽

Author(s):

Atakan Turgutkaya ◽

Gülay Aşçı

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Cardiovascular Events ◽

Pulse Wave ◽

Morbidity And Mortality ◽

Diabetic Patients

Abstract Background Cardiovascular events are seen more frequently after the age of 60 and they are a significant cause of morbidity and mortality. Arterial stiffness is a property that can be expressed by pulse wave velocity and this value is assumed to be a predictor of cardiovascular events. Patients with chronic kidney disease and dysregulated blood sugar have increased atherosclerosis and arterial stiffness, but the relationship between physiological levels of Hba1c and arterial stiffness is less clear in chronic kidney disease patients without diabetes mellitus. Objectives Here, we aimed to investigate the degree of arterial stiffness among non-diabetic, non-dialysis dependent chronic kidney disease patients with physiological HbA1c levels. Methods We enrolled 51 patients who were followed up at Ege University Hospital Nephrology Department between February and June 2015. Non-diabetic, non-dialysis dependent chronic kidney disease patients were included in the study. Blood pressure and pulse wave velocity were measured with an applanation tonometry device (Sphygmocor Vx Software Atcor Medical, Australia). Correlations between pulse wave velocity and the aforementioned parameters were investigated (see below). Results We detected a significant correlation between pulse wave velocity and systolic blood pressure (p=0.0001) and Hba1c (p=0.044) separately. There was an inverse correlation with creatinine clearance (p=0.04). We also detected a significant correlation with serum phosphorus level (p=0.0077) and furosemide use (p=0.014). No correlations were found among the other parameters. Conclusions Arterial stiffness is an important predictor of cardiovascular events and measuring it is an inexpensive method for estimating morbidity and mortality. Our study supports the importance of measuring arterial stiffness and of controlling blood glucose levels, even at physiological Hba1c values, especially for chronic kidney disease patients.

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6.BRACHIAL-ANKLE PULSE WAVE VELOCITY AND CHRONIC KIDNEY DISEASE AS A PROGNOSTIC IMPACT IN HYPERTENSION

Artery Research ◽

10.1016/j.artres.2009.06.018 ◽

2009 ◽

Vol 3 (3) ◽

pp. 96 ◽

Cited By ~ 1

Author(s):

Miyuki Onishi ◽

Mitsuru Ohishi ◽

Takashi Takagi ◽

Yuji Tatara ◽

Nozomi Kato ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Prognostic Impact

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Correlations between Total Antioxidant Capacity and 8-Hydroxydeoxyguanosine with Carotid-Femoral Pulse Wave Velocity in Chronic Kidney Disease

The Indonesian Biomedical Journal ◽

10.18585/inabj.v12i3.1241 ◽

2020 ◽

Vol 12 (3) ◽

pp. 267-74

Author(s):

Mochammad Yusuf Alsagaff ◽

Budi Susetyo Pikir ◽

Mochammad Thaha Thaha ◽

Hendri Susilo

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Pulse Wave Velocity ◽

Serum Creatinine ◽

Antioxidant Capacity ◽

Wave Velocity ◽

Total Antioxidant Capacity ◽

Pulse Wave ◽

Total Antioxidant

BACKGROUND: Chronic kidney disease (CKD) is often associated with an increased risk of cardiovascular disease. Cardiovascular disease in CKD can be affected by oxidative stress and inflammation. The oxidative stress can affect arterial stiffness, especially in patients with CKD, which will increase the risk of cardiovascular disease. This study aimed to explain the correlation between total antioxidant capacity (TAC) and 8-hydroxydeoxyguanosine (8-OHdG) with carotid-femoral pulse wave velocity (cf-PWV) in patients with CKD.METHODS: Forty-three CKD patients was included in this cross-sectional study. TAC was measured from serum samples by colorimetric method and 8-OHDG was measured from urine by enzyme-linked immunoassay method. cf-PWV was measured by Doppler ultrasound as a diagnostic tool for arterial stiffness.RESULTS: Significant correlations were found between age, estimated glomerular filtration rate (e-GFR), Hemoglobin A1C (HbA1C), serum creatinine, cystatin-C, and severity of CKD with urinary 8-OHdG levels. Serum creatinine, cystatin-C, severity of CKD, age, high-density lipoprotein (HDL), e-GFR, and HbA1C also had significant correlations with serum TAC levels. Other significant correlations between e-GFR, HbA1C, serum creatinine, cystatin-C, and severity of CKD with cf-PWV were also obtained. A significant negative correlation was obtained between serum TAC and cf-PWV with moderate levels of correlation coefficient (r=-0.504).CONCLUSION: There was a negative correlation between TAC and cf-PWV, but there was no significant correlation between 8-OHdG and cf-PWV in patients with CKD.KEYWORDS: chronic kidney disease, total antioxidant capacity, 8-hydroxydeoxyguanosine, carotid-femoral pulse wave velocity

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Telomere Length and Arterial Stiffness Reflected by Brachial–Ankle Pulse Wave Velocity: A Population-Based Cross-Sectional Study

Journal of Personalized Medicine ◽

10.3390/jpm11121278 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1278

Author(s):

Kyi Mar Wai ◽

Sawada Kaori ◽

Ken Itoh ◽

Okuyama Shinya ◽

Yuka Uchikawa ◽

...

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Tail Length ◽

Population Based ◽

Cross Sectional Study ◽

Biological Aging ◽

Sectional Study ◽

Cross Sectional

Telomere (TL) is a biomarker of biological aging, and its shortening is associated with major risk factors for cardiovascular diseases (CVD). This study aimed to identify whether TL is associated with arterial stiffness as reflected by brachial–ankle pulse wave velocity (baPWV). This population-based cross-sectional study involved 1065 individuals in the Iwaki area, Japan. Total TL length and TL G-tail length were measured by hybridization protection assay. The baPWV was measured on the right and left sides using a non-invasive vascular screening device. The associations between TL and baPWV were assessed by multivariate linear regression. Compared with the shortest total TL tertile, the longest total TL group showed a significant decrease in baPWV (lowest vs. highest tertile: adjusted beta: −41.24, 95% confidence interval (CI): −76.81, −5.68). The mean baPWV decreased with a longer TL (TL G-tail length: p trend < 0.001, total TL: p trend < 0.001). TL G-tail and total TL lengths were inversely associated with baPWV, implicating TL shortening in the development of CVD. This study provides evidence of the factors influencing CVD risks at a very early stage when individuals can still take necessary precautions before CVD gives rise to a symptomatic health outcome.

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