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Arterial Stiffening and Clinical Outcomes in Dialysis Patients

Akihiko Kato1

  • 1Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Japan.

Pulse (Basel, Switzerland)
|November 21, 2015
PubMed

Insights

Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), is elevated in dialysis patients and predicts cardiovascular outcomes better than CAVI. It also links to obesity and muscle loss, increasing cardiovascular event risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Cardiovascular disease (CVD) significantly impacts morbidity and mortality in dialysis patients.
  • Arterial stiffness is a key contributor to CVD, with brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) being common assessment parameters.
  • Dialysis patients exhibit increased arterial stiffness (baPWV and CAVI) compared to the general population.

Purpose of the Study:

  • To compare the efficacy of baPWV and CAVI in assessing arterial stiffness and predicting cardiovascular outcomes in hemodialysis (HD) patients.
  • To explore the relationship between arterial stiffness, sarcopenia, obesity, and cardiovascular risk in HD patients.
  • To investigate the potential of arterial stiffness as an early indicator of cognitive decline in dialysis patients.

Main Methods:

  • Assessment of brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI).
  • Correlation analysis between arterial stiffness parameters, cardiovascular events, sarcopenia, and abdominal obesity.
  • Review of existing literature on arterial stiffness and cognitive function in elderly and dialysis populations.

Main Results:

  • Increased baPWV and CAVI are observed in dialysis patients.
  • Higher baPWV is associated with carotid atherosclerosis, diastolic left ventricular dysfunction, and all-cause/cardiovascular mortality in HD patients.
  • baPWV demonstrates superior predictive value for cardiovascular outcomes compared to CAVI in HD patients.
  • Arterial stiffness is linked to sarcopenia and abdominal obesity, suggesting increased CV risk in sarcopenic obesity.
  • Arterial stiffness is associated with cognitive decline in the elderly, but its role in dialysis patients remains unclear.

Conclusions:

  • baPWV is a more effective predictor of cardiovascular outcomes than CAVI in hemodialysis patients.
  • Arterial stiffness, sarcopenia, and obesity are interconnected, contributing to elevated cardiovascular risk in dialysis patients.
  • Further research is required to determine if arterial stiffness can serve as an early marker for cognitive impairment in dialysis patients.

Keywords:
Brachial-ankle pulse wave velocityCardio-ankle vascular indexCognitive functionHemodialysisMortalitySarcopenic obesity

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