Arterial stiffness may predict renal and cardiovascular prognosis in autosomal-dominant polycystic kidney disease

Sági, Balázs; Késői, István; Késői, B; Vas, Tibor; Csiky, Botond; Kovács, Tibor; Nagy, Judit

doi:10.1556/2060.105.2018.2.17

Cited by 10 publications

(13 citation statements)

References 51 publications

(60 reference statements)

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Section: Discussionmentioning

confidence: 98%

“…The present meta-analysis accumulated all current evidence con- predicting the onset of end-stage kidney disease. 61 It has been also…”

Section: Discussionmentioning

confidence: 98%

“…The importance of vascular dysfunction in ADPKD patients has been indicated by recent research, supporting that increased arterial stiffness is associated with progressive loss of renal function, predicting the onset of end‐stage kidney disease 61 . It has been also suggested that concurrent hyperaldosteronism represents a significant cardiovascular risk factor, as inappropriate secretion of aldosterone was linked to endothelial damage and metabolic dysfunction 62 .…”

Section: Discussionmentioning

confidence: 99%

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Markers of endothelial dysfunction and arterial stiffness in patients with early‐stage autosomal dominant polycystic kidney disease: A meta‐analysis

2020

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Objectives Autosomal dominant polycystic kidney disease (ADPKD) is characterised by increased rates of cardiovascular complications leading to significant morbidity and mortality. This meta‐analysis aims to evaluate whether the disease is linked to endothelial dysfunction and arterial stiffness during its early stages. Methods Medline, Scopus, CENTRAL, Web of Science, Clinicaltrials.gov and Google Scholar databases comparing ADPKD patients with preserved renal function to healthy controls were included. The outcomes of interest were brachial flow‐mediated dilatation, carotid‐femoral pulse wave velocity, augmentation index, carotid intima‐media thickness and central systolic blood pressure, plasma ADMA or homocysteine levels. Standardised mean differences (SMDs) were estimated by a random‐effects model in R‐3.6.3. Results A total of 27 studies were included, comprising 1967 individuals. ADPKD was linked to significantly lower flow‐mediated dilatation (SMD: −1.44, 95% CI: [−2.35, −0.53]) and higher pulse wave velocity (SMD: 1.44, 95% CI: [0.22, 2.66]) and carotid intima‐media thickness (SMD: 1.02, 95% CI: [0.57, 1.47]). No significant associations were noted regarding augmentation index (SMD: 0.62, 95% CI: [−0.19, 1.43]) and central systolic blood pressure (SMD: 1.84, 95% CI: [−0.12, 3.80]). Plasma homocysteine was significantly higher in ADPKD (SMD: 0.81, 95% CI: [0.16, 1.45]), while no difference was calculated for ADMA levels (SMD: 1.14, 95% CI: [−0.25, 2.53]). Conclusions Early‐stage ADPKD patients present increased vascular stiffness and endothelial dysfunction, as reflected by low flow‐mediated dilatation and elevated values of pulse wave velocity, carotid intima‐media thickness and plasma homocysteine. The exact effects of early arterial stiffness on long‐term outcomes remain to be elucidated.

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Section: Discussionmentioning

confidence: 98%

“…The present meta-analysis accumulated all current evidence con- predicting the onset of end-stage kidney disease. 61 It has been also…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Markers of endothelial dysfunction and arterial stiffness in patients with early‐stage autosomal dominant polycystic kidney disease: A meta‐analysis

2020

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“…In our study, the severity of CKD was correlated with grade 3 hypertension and the occurrence of stroke. Vascular stiffness measured by pulse wave velocity is a predictive marker of chronic kidney disease progression in patients with ADPKD [16]. More than half of the patients had a GFR >30 ml/min/1.73m 2 and more than 60% (n=15) had an increased renal volume.…”

Section: Discussionmentioning

confidence: 99%

Autosomal Dominant Polycystic Kidney Disease: An Unknown Disease in Chad

G¹,

A²,

Soukaya³

et al. 2023

Int J Nephrol Kidney Fail

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Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic renal disease. After about ten years of evolution, it leads to a slow and progressive loss of kidney function eventually causing renal insufficiency and kidney failure. Few data exist on this pathology in Africa and Chad. The objective of this study was to analyze the epidemiological, diagnostic and therapeutic aspects of ADPKD. Methodology: This was a multicenter cross-sectional, descriptive and analytical study conducted over a period of 34 months in two hospitals in N’Djamena, Chad. All patients aged 15 years and above, having a family history of polycystic kidney disease, which were hospitalized or who were coming for consultation that met the unified criteria for ultrasonographic diagnoses (Ravine criteria modified by Pei) of ADPKD were included in the study. The clinical, paraclinical, therapeutic and evolutionary criteria for these patients had been studied. Results: There were a total of 26 cases of polycystic kidney disease that had a hospital prevalence of 1.16%. The average age was 42.4 years with extremes ranging from 15-70 years and a sex ratio of 1.3. The family survey had shown that parental consanguinity was present in 34.6% (n=9). The prevalence of hypertension was 53.8% (n=14). The mean serum creatinine was 45 mg/l with extremes ranging from 4.5 to 274.42 mg/l. It was noted that 65.3% (n=17) had chronic kidney disease with a GFR >30 mL/min/1.73m2 . During diagnosis 26.9% (n=7) had end-stage renal disease (ESRD), while 2 patients progressed to ESRD two years after diagnosis. One patient was hospitalized for chronic hemodialysis. No patient had received a kidney transplant and no patient had undergone a molecular biology and genetics study or had been treated with Tolvaptan. Conclusion: In Chad, the hospital prevalence of ADPKD was 1.16%, affecting young adults (average age of 42.4 years) with a male predominance. Management is usually late and remains limited to symptomatic treatment with complications such as chronic renal failure. Abbreviations: ADPKD: Autosomal Dominant Polycystic Kidney Disease, CRF: Chronic Renal Failure, ESRD: End-Stage Renal Disease, CVA: Cerebro Vascular Accident

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“…Arterial stiffness can be measured by several methods [7,8]. With most of the available devices parallel with the measurement of PWV, other parameters can also be evaluated, which correlate with PWV and each other, but also reflect on different features of the vasculature.…”

Section: Introductionmentioning

confidence: 99%

Integrated Central Blood Pressure-Aortic Stiffness Risk Categories and Cardiovascular Mortality in End-Stage Renal Disease

Nemcsik

Batta

Tabák

et al. 2019

Journal of Hypertension

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Background: Our aim was to study the predictive power of integrated central blood pressure-aortic stiffness (ICPS) risk categories on cardiovascular (CV) mortality in end-stage renal disease (ESRD) patients. Methods: This is a secondary analysis of a prospective study of 91 ESRD patients on hemodialysis therapy. At baseline, pulse wave velocity (PWV), central systolic blood pressure (cSBP) and central pulse pressure (cPP) were measured and patients were followed up for CV mortality for a median 29.5 months. Based on the shape of the association of each individual ICPS parameter with the CV outcome, patients were assigned ICPS scores: one point was given, if either the cSBP value was in the 3rd, or if the PWV or cPP was in the 2nd or 3rd tertiles (ICPS range: 0-3). We then evaluated the role of ICPS risk categories (average: 0-1, high: 2, very high: 3 points) in the prediction of CV outcomes using Cox proportional hazard regression analysis and compared its discrimination (Harrell's C) to that of each of its components. Results: We found a strong dose-response association between ICPS risk categories and CV outcome (high risk HR = 2.62, 95% CI: 0.82-8.43, p for trend = 0.106; very high risk HR = 10.03, 95% CI: 1.67-60.42, p = 0.02) even after adjustment for multiple potential confounders. ICPS risk categories had a modest discrimination (C: 0.622, 95% CI: 0.525-0.719) that was significantly better than that of cSBP (dC: 0.061, 95% CI: 0.006-0.117). Conclusion: The ICPS risk categories may improve the identification of ESRD patients with high CV mortality risk. H I G H L I G H T S • Integrated evaluation of central blood pressure and stiffness (ICPS) may improve risk prediction. • ICPS risk categories were developed and tested in end-stage renal disease (ESRD). • Very high ICPS risk category is a strong predictor of cardiovascular mortality in ESRD.

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Arterial stiffness may predict renal and cardiovascular prognosis in autosomal-dominant polycystic kidney disease

Cited by 10 publications

References 51 publications

Markers of endothelial dysfunction and arterial stiffness in patients with early‐stage autosomal dominant polycystic kidney disease: A meta‐analysis

Markers of endothelial dysfunction and arterial stiffness in patients with early‐stage autosomal dominant polycystic kidney disease: A meta‐analysis

Autosomal Dominant Polycystic Kidney Disease: An Unknown Disease in Chad

Integrated Central Blood Pressure-Aortic Stiffness Risk Categories and Cardiovascular Mortality in End-Stage Renal Disease

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