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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

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Estimating central blood pressure in the extreme vascular phenotype of advanced kidney disease

Pierre Boutouyrie1, Gérard M London2, James E Sharman3

  • 1Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Institut National de la Santé et de la recherche médicale, unité mixte de recherche 970, Paris, France; Department of Pharmacology, University Paris Descartes, Paris, France.

Kidney International
|September 17, 2016
PubMed

Insights

Estimating central blood pressure using peripheral tonometry is unreliable in chronic kidney disease patients. This study examines the reasons for these discrepancies and the limitations of current monitoring technologies.

Area of Science:

  • Cardiovascular Physiology
  • Nephrology
  • Biomedical Engineering

Background:

  • Peripheral tonometry is a non-invasive method for estimating central blood pressure.
  • Previous research by Carlsen et al. indicated significant inaccuracies in this method for chronic kidney disease (CKD) patients.
  • Understanding these discrepancies is crucial for accurate cardiovascular risk assessment in CKD.

Purpose of the Study:

  • To explore the implications of unreliable central blood pressure estimation in CKD patients.
  • To analyze the technical requirements for validating central blood pressure monitors.
  • To investigate potential causes for differences between CKD populations and general study cohorts.

Main Methods:

  • Review of technical validation criteria for central blood pressure devices.
  • Comparative analysis of physiological characteristics in CKD versus non-CKD populations.
  • Critical appraisal of the methodology and findings presented by Carlsen et al.

Main Results:

  • Peripheral tonometry-based central blood pressure estimation is not validated for CKD patients.
  • Discrepancies may arise from altered vascular properties and device calibration issues in CKD.
  • Technical validation protocols may not adequately account for CKD-specific pathophysiology.

Conclusions:

  • Current methods for estimating central blood pressure from peripheral tonometry are inadequate for CKD patients.
  • Further research is needed to develop and validate accurate methods for this population.
  • Clinical guidelines may need revision regarding central blood pressure monitoring in CKD.

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