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Updated: Jan 4, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular changes in patients with mild-to-moderate chronic kidney disease compared with healthy subjects: a
Anna M Asp1,2, Carin Wallquist3,4, Anette Rickenlund1,2
1Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
Insights
Cardiovascular changes in mild-to-moderate chronic kidney disease (CKD) progress slowly over five years. Intensive management of blood pressure and risk factors appears crucial for slowing cardiovascular disease progression in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Limited understanding exists regarding the longitudinal changes in cardiovascular parameters among individuals with mild-to-moderate chronic kidney disease (CKD).
- Cardiovascular complications are a major concern in CKD patients, necessitating a deeper insight into their temporal progression.
Purpose of the Study:
- To investigate the 5-year changes in various cardiovascular biomarkers in patients with mild-to-moderate CKD compared to healthy controls.
- To assess the impact of intensive management of hypertension and cardiovascular risk factors on these changes.
Main Methods:
- A longitudinal study involving 54 patients with CKD stages 2-3 and 54 healthy controls.
- Evaluated parameters included ambulatory blood pressure (BP) monitoring, ankle-brachial index (ABI), carotid and cardiac ultrasound (measuring left ventricular mass index - LVMI), and biochemical analyses.
- CKD patients received close monitoring and management for hypertension and other cardiovascular risk factors.
Main Results:
- While renal function declined in both groups, no significant difference in the rate of decline was observed.
- CKD patients showed no increase in blood pressure variables over time, unlike controls who exhibited increased systolic BP.
- Ankle-brachial index (ABI) slightly increased in CKD patients, influenced by phosphate levels, whereas common carotid artery diameter showed a significant increase only in controls. Left ventricular mass index (LVMI) increased in both groups.
Conclusions:
- Cardiovascular changes in patients with mild-to-moderate CKD progress relatively slowly over a 5-year period.
- Effective blood pressure control and management of other cardiovascular risk factors are vital in mitigating cardiovascular involvement in CKD.
- This highlights the importance of dedicated and proactive care for patients with mild-to-moderate CKD to manage cardiovascular risks.
Background:
There is limited knowledge about how cardiovascular parameters change over time in patients with mild-to-moderate chronic kidney disease (CKD). We studied several cardiovascular biomarkers over a 5-year period in patients with mild-to-moderate CKD and in healthy controls.
Methods:
Fifty-four patients with CKD stages 2-3 and 54 controls were included. The CKD patients were closely monitored and well controlled for hypertension and other cardiovascular risk factors. Ambulatory blood pressure (BP) monitoring, ankle-brachial index (ABI), carotid and cardiac ultrasound (including measurement of the left ventricular mass index (LVMI)), and biochemical analyses were evaluated.
Results:
Renal function decreased in both groups, with no significant difference in the change over time. In the CKD patients, none of the BP variables increased over time, but in the controls, average 24-h and daytime systolic BP increased significantly. ABI increased slightly in the CKD patients (P<0·001), but not in the controls (P = 0·963), and phosphate had a significant positive effect on ABI. Although in the CKD patients, there was no significant increase over time in common carotid artery diameter (P = 0·274), there was a small but significant increase in the controls (P = 0·001). LVMI increased significantly over time in both groups.
Conclusions:
In our study of patients with mild-to-moderate CKD, the progression of cardiovascular changes over time was relatively slow. Good BP control and treatment of other risk factors may have contributed to slow the progress of cardiovascular involvement, which emphasizes the importance of dedicated care in this population.
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