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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

Clinical assessment of atherosclerotic parameters and cardiac function in chronic hemodialysis patients

Mayuko Akamatsu1, Tetsuya Ogawa, Ayuko Fujiu

  • 1Department of Medicine, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Clinical and Experimental Nephrology
|August 15, 2009
PubMed

Insights

In chronic hemodialysis patients, atherosclerosis markers like mean intima-media thickness (mean IMT) and aortic calcification index (ACI) are linked. Reduced cardiac function, specifically left ventricular (LV) function, is associated with increased arterial stiffness and vascular calcification.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Radiology

Background:

  • Atherosclerosis is a significant concern in patients undergoing chronic hemodialysis (HD).
  • Key indicators of atherosclerosis include carotid mean intima-media thickness (mean IMT), pulse wave velocity (PWV), and aortic calcification index (ACI).
  • The relationship between these atherosclerosis markers and cardiac function in HD patients requires further investigation.

Purpose of the Study:

  • To investigate the interrelationships among different atherosclerosis parameters (mean IMT, PWV, ACI).
  • To determine which atherosclerotic parameters are most closely associated with cardiac function, specifically left ventricular (LV) geometry and function, in chronic HD patients.

Main Methods:

  • Sixty-nine maintenance HD patients were assessed for mean IMT (carotid ultrasonography), PWV (blood volume plethysmography), and ACI (abdominal CT).
  • Echocardiography was used to evaluate LV geometry and function (e.g., fractional shortening).
  • Serum levels of lipids, albumin, C-reactive protein (CRP), calcium, and phosphate were measured.

Main Results:

  • Mean IMT showed a positive correlation with ACI (r=0.461, P<0.0001) and a trend towards correlation with PWV.
  • PWV positively correlated with ACI (r=0.494, P≤0.0001).
  • Mean IMT correlated with LV mass index (r=0.273, P=0.0228), while fractional shortening (FS) negatively correlated with PWV (r=-0.293, P=0.0141) and ACI (r=-0.289, P=0.0158).
  • Multivariate analysis revealed independent associations between LV mass index and mean IMT, systolic blood pressure, pulse pressure, and hemoglobin.
  • FS was independently associated with ACI, PWV, and CRP.

Conclusions:

  • Atherosclerosis, characterized by increased vascular calcification and arterial stiffness, is linked to reduced left ventricular (LV) function in chronic HD patients.
  • Mean IMT and ACI are significant indicators of atherosclerosis in this population.
  • Arterial stiffness (PWV) and vascular calcification (ACI) are associated with impaired cardiac contractility (FS).
Abstract

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