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Background: Renal function is a major predictor of vascular function and cardiovascular diseases. Little information exists about the effect of specific renal diseases on vascular function in chronic kidney diseases (CKD). Methods: One hundred and twenty patients (60 with IgA nephropathy, IgAN, and 60 with polycystic kidney disease, PKD) with CKD stages 1–4 were studied and compared. Pulse-wave velocity was measured by the digital volume pulse (DVP) method and stiffness index (SI_DVP) was derived. Results: All CKD (IgAN and PKD) patients had increased SI_DVP compared to controls (10.39 vs. 8.87 ± 1.79 m/s, p = 0.008). PKD patients had increased SI_DVP compared to IgAN and controls (11.14 ± 2.19, 9.66 ± 2.02 and 8.87 ± 1.79 m/s, respectively, p < 0.001). An inverse correlation was found between SI_DVP and glomerular filtration rate in all CKD (IgAN and PKD) patients (p = 0.001) and in IgAN alone (p < 0.01), but not in PKD. With multivariate regression analysis, only age and 24-hour systolic blood pressure exerted independent effects on SI_DVP. Conclusions: Compared to controls, arterial stiffness was increased in CKD patients. However, arterial stiffening was more pronounced in PKD than in IgAN, suggesting that vascular function is not similarly altered in etiologically different CKD groups. The fact that blood pressure was an independent risk factor underscores a therapeutic opportunity.

BackgroundThe metabolic syndrome is associated with modest but independent and additive risk of new onset chronic kidney disease (CKD) in several studies. The purpose of our study was to determine whether metabolic syndrome and other cardiovascular risk factors (hyperuricaemia and smoking) are associated with the progression of IgA nephropathy (IgAN).MethodsTwo hundred and twenty three IgAN patients (107 with and 116 without metabolic syndrome) were examined. The primary renal end point was doubling of serum creatinine; secondary end points were reaching eGFR of ≤ 60 ml/min/1,73m2 or eGFR of ≤30 ml/min/1.73 m2, and end-stage renal disease, ESRD (the composite of serum creatinine ≥500 μmol/l, initiation of dialysis treatment or transplantation). The association of metabolic syndrome with renal end points was examined using the Kaplan-Meier method and Cox models.ResultsMetabolic syndrome established at the diagnosis or during follow-up of IgAN patients was significantly associated with the primary renal end point (unadjusted hazard ratio of doubling of serum creatinine, 95% confidence interval: 1.96 (1.17–1.33, p = 0.011). The association remained significant after adjustment for confounders: 1.70 (1.02–3.83, p = 0.040). Results were similar for secondary end points except ESRD which was not associated with the presence of metabolic syndrome. Hyperuricaemia and smoking were independent risk factors of progression. Survival curves stratified on metabolic syndrome status showed significant differences for the end points (p = 0.017–0.001) except for ESRD.ConclusionsEarly diagnosis and treatment of metabolic syndrome, hyperuricaemia and smoking may be an additional cost-effective strategy for preventing the progression of IgAN.