Aortic and large artery compliance in end-stage renal failure

London, Gérard M.; Marchais, Sylvain J.; Safar, Michel E.; Genest, Albert F.; Guérin, Alain P.; Mëtivier, Fabien; Chedid, Khalil; London, Alèna M.

doi:10.1038/ki.1990.19

Cited by 354 publications

(224 citation statements)

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“…Several studies have shown that modifications of the vessel wall properties are common in haemodialysis patients and after renal transplantation. [5][6][7][8] . In renal transplant recipients, arterial distensibility of large arteries is reduced and the impaired arterial buffering capacity seems to contribute to cardiovascular morbidity after renal transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Structural and mechanical properties of the arterial wall are altered in patients with renal failure. [5][6][7][8] It has been shown that the distensibility of large arteries is reduced in haemodialysis patients and in renal transplant recipients. [6][7][8] Moreover it had been demonstrated that intima-media-thickness is increased in end-stage renal failure and is related to the mechanical properties of the arterial wall.…”

Section: Introductionmentioning

confidence: 99%

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A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

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The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 ؎ 3/80 ؎ 2 mm Hg at entry and 133 ؎ 3/82 ؎ 2 mm Hg after 2 years in the normotensive group, 146 ؎ 4/90 ؎ 3 mm Hg at entry and 145 ؎ 3/87 ؎ 2 mm Hg after 2 years in the hypertensive group (P Ͻ 0.01, normotensives vs hypertensives). The distens-

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

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“…Arterial enlargement is a process associated with supposedly normal aging 32 but has also been associated with pathological conditions, such as hypertension in menopausal women, 33 hypertension, 34,35 CKD, 6 and end-stage renal disease patients. 36 In hypertensive patients, an increase in aortic diameter has been independently associated with target organ damage, such as cardiac hypertrophy. The reason why arterial dilation might predispose to premature death is still poorly understood.…”

Section: Discussionmentioning

confidence: 99%

Large Artery Stiffening and Remodeling Are Independently Associated With All-Cause Mortality and Cardiovascular Events in Chronic Kidney Disease

et al. 2012

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Chronic kidney disease, even at moderate stages, is characterized by a high incidence of cardiovascular events. Subclinical damage to large arteries, such as increased arterial stiffness and outward remodeling, is a classical hallmark of patients with chronic kidney disease. Whether large artery stiffness and remodeling influence the occurrence of cardiovascular events and the mortality of patients with chronic kidney disease (stages 2–5) is still debated. This prospective study included 439 patients with chronic kidney disease (mean age, 59.8±14.5 years) with a mean measured glomerular filtration rate of 37 mL/min per 1.73 m 2 . Baseline aortic stiffness was estimated through carotid-femoral pulse wave velocity measurements; carotid stiffness, diameter, and intima-media thickness were measured with a high-resolution echotracking system. For the overall group of patients, the 5-year estimated survival and cumulative incidence of cardiovascular events were 87% and 16%, respectively. In regression analyses adjusted on classical cardiovascular and renal risk factors, aortic stiffness remained significantly associated with all-cause mortality (for 1 SD, Cox model–derived relative risk [95% CI], 1.48 [1.09–2.02]) and with fatal and nonfatal cardiovascular events (for 1 SD, Fine and Gray competing risks model–derived relative risk [95% CI], 1.35 [1.05–1.75]). Net reclassification improvement index was significant (29.0% [2.3–42.0%]). Carotid internal diameter was also independently associated with all-cause mortality. This study shows that increased aortic stiffness and carotid internal diameter are independent predictors of mortality in patients with stages 2 to 5 chronic kidney disease and that aortic stiffness improves the prediction of the risk.

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“…Increased PWV (indicating increased arterial stiffness) has been associated with increasing age, arterial blood pressure, 2 diabetes, 3 smoking, 4 and endstage renal disease. 5 Emerging evidence has also suggested an association between increasing arterial stiffness (as measured by PWV) and cardiovascular mortality. 6,7 Coexistent raised arterial blood pressure in diabetes is associated with increased cardiovascular morbidity and mortality.…”

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confidence: 99%