Association of Arterial Stiffness With Chronic Kidney Disease Progression and Mortality

Abstract

Chronic kidney disease (CKD) is a major public health concern. Despite many potentially life-threatening conditions that can accompany kidney disease, cardiovascular disease (CVD) remains the leading cause of death in these patients. Adjusted-for-age mortality from CVD in patients with end-stage renal disease is 10-30 times higher than in the general population. A decrease in renal function accelerates the development of cardiac pathology. Simultaneous exposure of CVD and CKD plays an important role in the relationship between arterial stiffness (AS) and estimated glomerular filtration rate. But there is a controversy as to whether the AS causes deterioration in kidney function, if renal dysfunction leads to AS, or the relationship is reciprocal. Hence, several studies that recruited high-risk populations reached a conclusion that comorbidities might lead to both AS and decline in kidney function over time. A number of studies have shown that several markers of AS, such as pulse pressure, central and peripheral pressure are associated with the development of CKD. This review takes into account the theoretical background, current status, and future potential of the techniques that measure AS within context of CKD assessment and management.

The association between brachial-ankle pulse-wave velocity and adverse cardiovascular events in 5719 community participants a prospective cohort study

“…Since baPWV is measured in the arteries, its value is a direct indicator of arterial stiffness and compliance [15]. A lower baPWV indicates better vascular elasticity, and a higher baPWV a reduction in vascular diameter, abnormal vascular function, and increased arterial stiffness, with the latter causing microvascular damage in the kidneys due to the increased resistance of the peripheral arteries [27]. These processes play key roles in the development of hypertension, diabetes mellitus, and CVDs [28,29].…”

Home-Based Exercise in Elderly Patients with Claudication and Chronic Kidney Disease Is Associated with Lower Progressive Renal Function Worsening: A 5-Year Retrospective Study

“…The concomitant presence of PAD and CKD is a major issue due to the high number of vascular aggressive factors, the related unfavorable cardiovascular clinical outcomes, and a possible negative renal disease progression [ 3 , 7 , 9 ]. This evolution, intermittent and in general unpredictable, may evolve to ESRD, driving the patients to a worsening of quality of life and posing a burden on the health service and the environment [ 34 , 35 , 36 ].…”

“…The disease, which may significantly impair walking ability, is associated with a high risk of adverse clinical outcomes [ 1 ]. In PAD, the risk of worsening kidney function is enhanced by arterial stiffness, with related markers found to be associated with the early development of chronic kidney disease (CKD) [ 3 ], region-specific vascular stiffness [ 4 ], metabolic factors [ 5 ], and contrast-induced nephropathy related to endovascular procedures [ 6 ]. On the other hand, the risk of PAD is increased by 1 to 4 times in the population with CKD, with an incidence rate among patients on hemodialysis of approximately 400 per 1000 patient-years [ 7 ].…”

Estimated pulse wave velocity is associated with all-cause mortality and cardiovascular mortality among adults with diabetes

“…Arterial stiffness is an important cardiovascular risk factor and strongly associated with increased mortality ( 1 , 2 ). Arterial stiffness can be assessed by carotid-femoral pulse wave velocity (cf-PWV), which is now listed in the guidelines for detecting organ damage caused by hypertension ( 3 ).…”