A Newly Estimated Glomerular Filtration Rate Is Independently Associated with Arterial Stiffness in Japanese Patients

Nakagawa, Naoki; Takahashi, Fumiyuki; Chinda, Junko; Kobayashi, Michie; Hayashi, Yoshikazu; Abe, Masahiko; Saijo, Yasuaki; Kikuchi, Kenjiro; Hasebe, Naoyuki

doi:10.1291/hypres.31.193

Cited by 45 publications

(38 citation statements)

References 27 publications

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“…15 CFPWV was not directly assessed in the Dutch study. Nakagawa et al, 20 in contrast to our findings, reported that arterial stiffness correlated with decreased eGFRcrea and increased with increasing stages of CKD (n ϭ 647, mean eGFRcrea 63.4 Ϯ 14.5 ml/min/1.73 m 2 , 37% with eGFRcrea Ͻ60 ml/min/1.73 m 2 ). Lack of CFPWV, exclusion of important metabolic parameters from multivariable models, and the use of hospital-based samples may account for the contrasting results.…”

Section: Discussioncontrasting

confidence: 99%

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Arterial Stiffness in Mild-to-Moderate CKD

Upadhyay¹,

Hwang

Mitchell

et al. 2009

Journal of the American Society of Nephrology

133

116

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Whether arterial stiffness correlates with mild-to-moderate CKD and albuminuria in the community is unclear. We studied the association between arterial stiffness and mild-to-moderate CKD and albuminuria in the Framingham Heart Study. CKD was present in 6.7% (181 of 2682) of participants and microalbuminuria was present in 8.2% (479 of 5818). The measures of arterial stiffness were the carotid femoral pulse wave velocity, forward pressure wave amplitude, central pulse pressure, augmentation pressure, augmentation index, and mean arterial pressure. In cross-sectional analyses, arterial stiffness did not associate with CKD (defined by estimated GFR Ͻ60 ml/min/1.73 m 2 ) in either age-and gender-adjusted or multivariable-adjusted linear regression models. Carotid femoral pulse wave velocity associated with both urinary albumin-to-creatinine ratio and microalbuminuria (P Ͻ 0.0001 after multivariable adjustment). In longitudinal analyses, we used logistic regression models to examine the associations between baseline arterial stiffness measures (exposure variables) and incident CKD or microalbuminuria (n ϭ 1675 for CKD analyses and n ϭ 1252 for microalbuminuria analyses). Baseline arterial measures did not associate with incident CKD or incident microalbuminuria. In summary, arterial stiffness correlates with albuminuria but not with mild-to-moderate CKD.

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Section: Discussioncontrasting

confidence: 99%

“…These studies, however, have been limited by small samples of CKD subjects 16,17,19 -21 or the lack of data for carotid femoral pulse wave velocity (CFPWV), a gold standard measure of central arterial stiffness. 15,20 Therefore, the association of arterial stiffness and mild-to-moderate CKD warrants further examination.…”

mentioning

confidence: 99%

Arterial Stiffness in Mild-to-Moderate CKD

Upadhyay¹,

Hwang

Mitchell

et al. 2009

Journal of the American Society of Nephrology

133

116

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“…Some studies have shown that the arterial stiffness relates with age, body mass index, systolic blood pressure, diabetes and hypertension and independently associates decreased glomerular filtration rate. 36,37 A decreased excretion of EO in the patients with diminished glomerular filtration rate may be a further component of relationship between the declining glomerular filtration rate and increased arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

Selective association of endogenous ouabain with subclinical organ damage in treated hypertensive patients

et al. 2010

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According to previous studies endogenous ouabain (EO) closely correlates with high blood pressure, congestive heart failure and kidney disease in humans. Our aims were to analyse associations between plasma, urinary EO level and various markers of cardiovascular damage in treated hypertensive patients. Forty-one adult patients with hypertension and/or diabetes mellitus (DM) and/or chronic kidney disease (CKD) were studied. We assessed plasma and urinary EO, pro-brain natriuretic peptide and catecholamines, profile of ambulatory blood pressure monitor and cardiovascular status by echocardiography and echo-tracking. The highest level of plasma EO (19.7 ± 9.5 pmol l -1 ) was measured in hypertensive patients with DM and CKD. The nighttime mean arterial blood pressure independently correlated with the level of plasma EO (P ¼ 0.004), while independent predictor of the b-stiffness of carotid artery was the urinary EO (P ¼ 0.011). Elevated level of EO was associated with nighttime blood pressure and subclinical organ damage in treated hypertensive patients, suggesting possible role of EO in the pathogenesis of impaired diurnal blood pressure rhythm and arterial stiffness.

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“…The ankle-brachial pulse wave velocity (baPWV) was measured using a waveform analyzer (VP-1000; Colin Co., Komaki, Japan) after at least 5 min of rest, as previously reported. 15 The body surface area was calculated according to the following formula: body surface area¼0.6Âheight (m)+0.0128Âweight (kg)-0.1529. Diabetes mellitus was defined based on the World Health Organization criteria.…”

Section: Methodsmentioning

confidence: 99%

The balance of fetuin-A and osteoprotegerin is independently associated with diastolic dysfunction in hemodialysis patients

et al. 2011

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Fetuin-A and osteoprotegerin (OPG) are arterial calcification regulators, which are related to cardiovascular survival in hemodialysis patients. We hypothesized that a balance of these calcification regulators might mediate the progression of left ventricular (LV) diastolic dysfunction in hemodialysis patients. We recruited 63 hemodialysis patients and measured their serum fetuin-A, OPG, arterial stiffness, aortic calcification and echocardiographic parameters, including the transmitral early diastolic velocity/tissue Doppler mitral annular early diastolic velocity ratio (E/E¢), and analyzed the relationships between these variables. Fetuin-A levels were significantly and negatively correlated with the ankle-brachial pulse wave velocity (baPWV), aortic calcification score (AOCS), left atrial volume index (LAVI), LV mass index (LVMI) and E/E¢. OPG levels and the ratio of OPG to fetuin-A levels were significantly and positively correlated with the baPWV, AOCS, LAVI and E/E¢. A stepwise multiple regression analysis revealed that E/E¢ was independently correlated with fetuin-A levels (b¼À0.334, P¼0.02), OPG levels (b¼0.367, P¼0.01) and the ratio of OPG to fetuin-A (b¼0.295, P¼0.04). Categorizing the patients according to their serum fetuin-A and OPG levels revealed that patients with low fetuin-A and high OPG levels had the highest LAVI, LVMI and E/E¢ values after adjusting for potential confounders. Serum fetuin-A levels negatively reflected, whereas OPG levels and the ratio of OPG to fetuin-A positively reflected an increase in vascular and ventricular stiffness, leading to the aggravation of diastolic dysfunction. Therefore, based on our results, the balance of the tissue calcification regulators fetuin-A and OPG could mediate the progression of LV diastolic dysfunction in hemodialysis patients.

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A Newly Estimated Glomerular Filtration Rate Is Independently Associated with Arterial Stiffness in Japanese Patients

Abstract: Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease, and thus is

Cited by 45 publications

References 27 publications

Arterial Stiffness in Mild-to-Moderate CKD

Arterial Stiffness in Mild-to-Moderate CKD

Selective association of endogenous ouabain with subclinical organ damage in treated hypertensive patients

The balance of fetuin-A and osteoprotegerin is independently associated with diastolic dysfunction in hemodialysis patients

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