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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Arterial stiffness, pulse pressure, and the kidney
Michel E Safar1, Gérard E Plante, Albert Mimran2
1Faculty of Medicine, Paris Descartes University, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France; michel.safar@htd.aphp.fr.
American Journal of Hypertension
|December 7, 2014
Summary
Arterial stiffness, indicated by pulse pressure (PP), significantly predicts kidney function decline in older adults with hypertension. This relationship highlights arterial stiffness as a key factor in hypertension-related kidney disease, beyond just blood pressure.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Gerontology
Background:
- Kidney contribution to hypertension traditionally linked to mean arterial pressure (MAP) and vascular resistance.
- Emerging evidence implicates pulse pressure (PP) and arterial stiffness in cardiovascular risk and age-related decline in glomerular filtration rate (GFR).
Purpose of the Study:
- To investigate the association between pulse pressure, arterial stiffness, and renal function in hypertensive individuals, particularly those aged 60 and older.
- To determine the role of arterial stiffness in the decline of GFR in renal transplant recipients.
Main Methods:
- Analysis of pulse pressure amplification, MAP, and proteinuria in hypertensive patients.
- Correlation studies between plasma creatinine, aortic stiffness, and GFR.
- Evaluation of arterial stiffness and GFR decline in renal transplant donors and recipients.
Main Results:
- Increased PP amplification (>10mm Hg) was observed in hypertensive patients and correlated with proteinuria.
- Aortic stiffness and plasma creatinine showed independent positive correlations with GFR decline.
- In renal transplant recipients, donor age and aortic stiffness were key predictors of GFR decline after 9 years.
Conclusions:
- Arterial stiffness, not solely vascular resistance, significantly mediates the relationship between PP and GFR in hypertensive individuals.
- Arterial stiffness is a crucial factor in age-associated GFR decline and post-transplant kidney function.
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