Peripheral arterial stiffness is correlated with intrarenal arteriolosclerosis according to biopsies from patients with kidney disease

Abstract

Aim To investigate the possible associations between intrarenal arteriolosclerosis as determine by renal biopsy and endothelial function as well as arterial stiffness measured by peripheral arterial tonometry (EndoPAT). Methods This was a cross‐sectional study. Patients who underwent both renal biopsy and EndoPAT were recruited, and intrarenal arteriolosclerosis was graded according to the pathological slice. Endothelial function and arterial stiffness were both measured by EndoPAT and were expressed by the reactive hyperemia index (RHI) and augmentation index (AIx), respectively. AIx@75, representing the AIx standardized to a heart rate of 75 bpm was also determined. Results In total, 113 patients were assessed, the mean age was 51 ± 13, and 68.1% were men. The natural logarithm RHI (LnRHI), AIx and AIx@75 were significantly different among different grades of intrarenal arteriolosclerosis (P = .030, P < .001, P < .001, respectively). In the multivariable adjusted model, for every SD increase in the AIx and AIx@75, the odds of having more severe arteriolosclerosis were 2.506 times (95% confidence interval [CI] 1.464‐4.288, P = .001] and 3.191 times (95% CI 1.780‐5.719, P < .001) higher, respectively, and the association between the LnRHI and intrarenal arteriolosclerosis was nullified (P = .059). The positive values of the AIx and AIx@75 for the diagnosis of severe intrarenal arteriolosclerosis were 0.80 (95% CI 0.73‐0.88, P < .001) and 0.78 (95% CI 0.70‐0.87, P < .001), respectively. Conclusion Subjects with more severe intrarenal arteriolosclerosis have greater peripheral vascular stiffness; AIx and AIx@75 reflected peripheral vascular stiffness could be used to identify patients with severe intrarenal arteriolosclerosis.

Osteocalcin association with vascular function in chronic kidney disease

“…The test was performed once per patient by skilled investigators following the protocol instructions. 19 Participants were tested at a temperature of 21…”

Evoking Awareness toward Muscular Arterial Remodeling and Stiffness

“…However, further works [20] revealed that high-resolution radial IMT can compete against carotid IMT in evaluating arterial remodeling burden and that it is also related to previous cardiovascular disease (CVD) and ischemia. An interesting study in renal artery biopsies reported a positive relationship between renal arteriosclerosis and augmentation index, a surrogate for peripheral arterial stiffness [21]. The main limitation of this study was borderline subject age for better performance of augmentation index [12].…”

Noninvasive markers of arterial stiffness and renal outcomes in patients with chronic kidney disease

“…First, intrarenal arteries are associated with generalized atherosclerosis when different measurements are used. 21 Second, arterial stiffness and CKD share similar risk factor profiles, such as age, gender, blood pressure, proteinuria, and so on. However, we found that the association between arterial stiffness and CKD outcomes remained significant after those risk factors were taken into consideration in analyses, which means that there are potential risks underlying these two pathophysiological processes.…”

“…However, there are some potential explanations. First, intrarenal arteries are associated with generalized atherosclerosis when different measurements are used 21 . Second, arterial stiffness and CKD share similar risk factor profiles, such as age, gender, blood pressure, proteinuria, and so on.…”