Carotid–Femoral Pulse Wave Velocity Could Be a Marker to Predict Cardiovascular and All-Cause Mortality of Hemodialysis Patients

Abstract

Among hemodialysis (HD) patients, cardiovascular disease (CVD) is recognized as a major contributor to the high risk of mortality, and emerging evidence has ascertained arterial stiffness as an independent predictor of adverse cardiovascular (CV) outcomes. We aimed to investigate the efficacy of arterial stiffness measurement in predicting CV and all-cause mortality in patients on HD (n = 130). Carotid–femoral pulse wave velocity (cfPWV) was measured by a validated tonometry system. A cfPWV of >10 m/s was used to assign patients to the arterial stiffness group (n = 64). Baseline and biochemical characteristics, as well as all-cause and CV mortality, were recorded. During the 3-year follow-up period, a total of 32 deaths (25%) occurred. The patients who died had clinically significant high cfPWV levels; were relatively old; and had hypoalbuminemia, low creatinine levels, and diabetes. After adjustment for the prognostic variables, patients with elevated cfPWV had significantly higher all-cause (p = 0.036) and CV mortality (p = 0.017), compared with the mortality rates in the normal group. In this study, cfPWV was found to be an independent predictor of all-cause and CV mortality in HD patients.

Effect of Menaquinone-7 Supplementation on Arterial Stiffness in Chronic Hemodialysis Patients: A Multicenter Randomized Controlled Trial

“…Firstly, the main outcome measured in our study was the change in cfPWV. Although cfPWV has been accepted as a standard tool for the assessment of arterial stiffness [31,32] and has been shown by a recent study to be an independent predictor of all-cause and cardiovascular mortality in patients with chronic HD patients [32], it is still a surrogate endpoint and not a hard clinical outcome. Therefore, the impact of vitamin K supplementation on clinical outcomes should be further explored.…”

The Prognostic Role of Serum β-Trace Protein Levels among Patients on Maintenance Hemodialysis

“…Besides diabetes and high blood pressure, patients having chronic kidney disease (CKD) also possess non-traditional, kidney-specific CV risk factors, including chronic inflammation, albuminuria, disturbed calcium and phosphorus homeostasis, uremic toxins, oxidative stress, and vascular calcifications [2,5]. Many studies have identified several factors that potentially predict adverse CV outcomes and overall survival of patients on maintenance hemodialysis (HD), including vascular status (aortic stiffness, ankle-brachial index, and extent of abdominal aorta calcification) [6][7][8], nutrition markers (albumin, creatinine, and lipid profiles) [9], and serum levels of galectin-3 [10], sclerostin [11], and uremic toxins (p-cresol sulfate, indoxyl sulfate, and carboxymethyllysine) [12][13][14].…”