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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Ambulatory blood pressure and endothelial dysfunction in patients with autosomal dominant polycystic kidney disease

Faruk Turgut1, Hüseyin Oflaz, Sule Namli

  • 1School of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul University, Capa, Istanbul, Turkey. farukturgut@yahoo.com

Renal Failure
|December 11, 2007
PubMed

Insights

Autosomal dominant polycystic kidney disease (ADPKD) patients who do not experience a nocturnal blood pressure dip have significantly impaired endothelial function. This endothelial dysfunction is linked to increased cardiovascular risks in ADPKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Cardiovascular disease is a leading cause of death in autosomal dominant polycystic kidney disease (ADPKD) patients.
  • Endothelial dysfunction (ED), an early sign of vascular damage, is observed in ADPKD.
  • The relationship between ambulatory blood pressure patterns and ED in ADPKD remains understudied.

Purpose of the Study:

  • To investigate the association between ambulatory blood pressure monitoring (ABPM) patterns and endothelial function in ADPKD patients.
  • To determine if non-dipper status in ADPKD is linked to endothelial dysfunction.

Main Methods:

  • Forty-one ADPKD patients with preserved renal function underwent 24-hour ABPM.
  • Patients were categorized into dipper and non-dipper groups based on nocturnal blood pressure decline.
  • Brachial artery endothelial function was assessed using high-resolution vascular ultrasound, measuring endothelial-dependent dilatation.

Main Results:

  • No significant differences in mean 24-hour systolic or diastolic blood pressure were found between dipper and non-dipper groups.
  • Non-dipper patients exhibited a significantly lower nocturnal fall rate in both systolic (0.98% vs. 11.1%) and diastolic (3.8% vs. 14.0%) blood pressure compared to dippers (p=0.001 for both).
  • Endothelial-dependent dilatation was significantly impaired in non-dippers (3.57%) compared to dippers (6.22%) (p=0.025).

Conclusions:

  • Non-dipper status in ADPKD is associated with significant endothelial dysfunction.
  • Impaired endothelial function in non-dipper ADPKD patients may contribute to increased cardiovascular morbidity and mortality.
  • ABPM and endothelial function assessment are crucial for cardiovascular risk stratification in ADPKD.

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