Arterial Stiffness and Renal Replacement Therapy: A Controversial Topic

Fischer, Edmundo Cabrera; Zócalo, Yanina; Galli, Claudia Inés; Wray, Sandra; Bia, Daniel

doi:10.1155/2015/729609

Cited by 13 publications

(12 citation statements)

References 36 publications

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“…We did not find any association between baseline levels biomarker of inflammation and vascular health and changes in PWV over a 6-month period. This could be because changes to the arterial stiffness develop over a longer period and are influenced to a greater degree by factors other than inflammation [63, 64]. …”

Section: Discussionmentioning

confidence: 99%

Inflammatory and Angiogenic Factors Linked to Longitudinal Microvascular Changes in Hemodialysis Patients Irrespective of Treatment Dose Intensity

Mitsides

Cornelis

Broers

et al. 2017

Kidney Blood Press Res

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Background: Cardiovascular disease is a major contributor to the poor outcomes observed in hemodialysis. We investigated the relationship between hemodialysis intensity and vascular parameters in high-dose (HDHD; >12hrs/week) and Conventional (CHD; ≤12hrs/week) hemodialysis intensity over a 6-month period. Methods: We present the 6-month longitudinal analysis of a 2-year multicenter study investigating the effects of HDHD on cardiovascular parameters. We used pulse wave velocity, 24hr ambulatory blood pressure and sublingual dark field capillaroscopy measurements to assess macro- and microcirculation on 6-monthly basis. Pro-inflammatory and endothelial biomarkers were also measured at 6-monthly intervals. Results: 47 participants (21 HDHD, 26 CHD) were studied. CHD were older (63.5±14.2 vs 53.7±12.6 yr; p=0.018), with shorter dialysis vintage (median 23 vs 61 months; p=0.001). There was considerable variability in the degree and direction of change of circulatory measurements over a 6-month period. Hemodialysis intensity (hrs/week) did not correlate to these changes, when adjusted for age, dialysis vintage and comorbidity. Higher levels of Interleukin (IL)-8 measured at baseline independently predicted an increase in the Perfused Boundary Region (5-25μm) of the endothelial glycocalyx (p=0.010) whilst higher levels of soluble Flt-1 had a significant inverse effect (p=0.002) in an adjusted linear model. Conclusion: Hemodialysis intensity did not predict changes in either macro- or microvascular parameters. Inflammation mediated through the IL-8 pathway predicted microvascular injury while Flt-1, a potential marker of angiogenesis and endothelial repair, might have a significant protective role. Further understanding of these pathways will be necessary to improve dialysis outcomes.

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Section: Discussionmentioning

confidence: 99%

Inflammatory and Angiogenic Factors Linked to Longitudinal Microvascular Changes in Hemodialysis Patients Irrespective of Treatment Dose Intensity

Mitsides

Cornelis

Broers

et al. 2017

Kidney Blood Press Res

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“…It should be noted that the study from Fortier included only 65 (21%) PD patients. Given that different dialysis modality may have distinct impact on arterial stiffness [23-25], the possible predictive value of PWV ratio in patients underwent PD or HD need to be further elucidated separately.…”

Section: Introductionmentioning

confidence: 99%

Aortic-Brachial Stiffness Mismatch and Mortality in Peritoneal Dialysis Patients

Bao

Wang

Tang³

2019

Kidney Blood Press Res

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Background/Aims: Possible predictive value of aortic-brachial arterial stiffness mismatch assessed by pulse wave velocity PWV ratio in peritoneal dialysis patients’ outcomes need to be further elucidated. The aim of this study is to investigate the predictor value of PWV ratio on peritoneal dialysis (PD) patients’ outcomes in China. Methods: In this longitudinal cohort study, patients who started PD during September 20, 2005, to February 05, 2008, were included. All the patients were followed until January 31, 2018. Aortic-brachial arterial stiffness mismatch was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity (PWV ratio). Results: A total of 181 incident PD patients were included. The median survival of patients in PWV ratio above median group (4.03 years, 95% CI 4.64-7.99 years) was shorter than that of PWV ratio below median group (10.43 years, 95% CI 9.74-11.12 years, p< 0.001). The cardiovascular mortality rate in PWV ratio above median group were significantly higher than that of PWV below median group (log rank test, p< 0.001). Univariate Cox regression analysis showed that both PWV ratio (HR 2.42, 95% CI 1.80-3.25, p< 0.001) and CF-PWV (HR 1.27, 95% CI 1.16-1.38, p< 0.001) were associated with high patients’ all-cause mortality. Multivariable Cox regression analysis showed that the PWV ratio was a strong and significantly predictor of cardiovascular mortality (HR 2.08 95% CI 1.16-3.71, p=0.014) after adjusting for coronary heart disease history (HR 2.39, 95% CI 1.20-4.76, p=0.013), diabetes mellitus history (HR 2.84, 95% CI 1.51-5.33, p=0.001). However, the CF-PWV was failed to be included as a significant predictor for both all-cause and CVD mortality in the multivariable Cox regression model. Conclusion: Aortic-brachial arterial stiffness mismatch as assessed by PWV ratio, a new arteries stiffness risk parameter, is a significant prognostic indicator of CVD mortality in PD patients. We demonstrated that the discriminative power of the PWV ratio for both all-cause and CVD mortality was better than that CF-PWV.

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“…Arterial stiffening is an unavoidable participant to ageing processes. Thus, the aorta and large arteries become progressively less distensible with advancing age, with resultant reduced capacity to buffer pulsations from the contracting ventricle (35,36).…”

Section: Discussionmentioning

confidence: 99%

Arterial stiffness in black African ancestry patients with chronic kidney disease living in Cameroon

Lemogoum

Halle

Mboule

et al. 2018

Cardiovasc. Diagn. Ther.

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Our findings suggest increased AS in Cameroonian CKD non-dialyzed as compared to dialyzed patients. Slower PWV in patients on maintenance hemodialysis suggests improvement of aortic distensibility following dialysis. However, further large-scale studies are needed to confirm our findings and to improve understanding of the underlying mechanisms of arterial stiffening in black African ancestry patients with CKD.

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Arterial Stiffness and Renal Replacement Therapy: A Controversial Topic

Cited by 13 publications

References 36 publications

Inflammatory and Angiogenic Factors Linked to Longitudinal Microvascular Changes in Hemodialysis Patients Irrespective of Treatment Dose Intensity

Inflammatory and Angiogenic Factors Linked to Longitudinal Microvascular Changes in Hemodialysis Patients Irrespective of Treatment Dose Intensity

Aortic-Brachial Stiffness Mismatch and Mortality in Peritoneal Dialysis Patients

Arterial stiffness in black African ancestry patients with chronic kidney disease living in Cameroon

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