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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 and Chronic Kidney Disease
Anne-Sophie Garnier1, Marie Briet1
1INSERM U1083, CNRS UMR 6214, Centre Hospitalo-Universitaire d'Angers, Université d'Angers, Angers, France.
Pulse (Basel, Switzerland)
|May 20, 2016
Summary
Chronic kidney disease (CKD) significantly increases cardiovascular disease risk. Large artery stiffness is common in CKD patients, contributing to cardiovascular events and potentially impacting kidney function decline.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Chronic kidney disease (CKD) is a significant public health issue, strongly linked to cardiovascular (CV) disease.
- CV mortality is substantially elevated in end-stage renal disease (ESRD) patients compared to the general population.
- Vascular remodeling, particularly large artery stiffness, is a hallmark of CKD, affecting renal and CV prognosis.
Purpose of the Study:
- To review the current understanding of large artery stiffening and remodeling in CKD.
- To evaluate the impact of arterial stiffness on CKD progression and CV disease incidence.
- To discuss the effects of kidney transplantation on arterial stiffness.
Main Methods:
- Review of clinical studies characterizing vascular remodeling in CKD stages 2-5 and ESRD.
- Analysis of longitudinal studies examining the association between aortic stiffness and estimated glomerular filtration rate (eGFR) decline.
- Examination of factors influencing arterial stiffness post-kidney transplantation.
Main Results:
- Increased large artery stiffness is consistently observed in CKD patients compared to those with normal renal function.
- Arterial stiffness contributes to the high incidence of CV disease in CKD.
- The impact of baseline aortic stiffness on CKD progression remains debated, with diabetes and other CV risk factors playing a role.
- Pulse pressure (central and peripheral) is consistently associated with incident CKD and eGFR decline.
- Kidney transplantation improves CV prognosis, but its effect on arterial stiffness is controversial, influenced by donor age, living donation, and mean blood pressure.
Conclusions:
- Large artery stiffening is a key feature of CKD, contributing to elevated CV risk.
- While pulse pressure is linked to CKD progression, the role of aortic stiffness in eGFR decline requires further investigation.
- Kidney transplantation offers CV benefits, with improvements in arterial stiffness dependent on specific donor and recipient factors.
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