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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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Association of cardiovascular structure and function with cerebrovascular changes and cognitive function in older

Laurien E Zijlstra1, Stella Trompet1,2, J Wouter Jukema1

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Aging
|January 8, 2020
PubMed

Insights

Arterial stiffness, measured by pulse wave velocity (PWV), is linked to cognitive decline in older patients with advanced chronic kidney disease. Higher PWV correlates with poorer memory, executive function, and psychomotor speed.

Area of Science:

  • Nephrology
  • Cardiology
  • Neurology

Background:

  • Chronic kidney disease (CKD) stage 4-5 impacts older patients significantly.
  • Cardiovascular disease is a major comorbidity in end-stage renal disease (ESRD).
  • Cognitive impairment is prevalent in ESRD patients.

Purpose of the Study:

  • To investigate the association between cardiovascular structure/function and cerebrovascular changes.
  • To examine the relationship between cardiovascular parameters and cognitive function in older ESRD patients.

Main Methods:

  • Prospective multicenter cohort study (COPE) of 85 older patients with CKD stage 4-5.
  • MRI assessment of aortic stiffness (pulse wave velocity [PWV]) and cardiac systolic function.
  • Evaluation of MRI-derived cerebrovascular changes and cognitive function domains.

Main Results:

  • No significant associations found between cardiovascular parameters and cerebrovascular changes.
  • Poorer cognitive function observed across all domains in patients with high PWV compared to low PWV.
  • After adjustments, only Trail Making Test A remained statistically significant (p=0.030) for high PWV.

Conclusions:

  • Higher PWV may be associated with lower cognitive function in older ESRD patients.
  • Arterial stiffness is a potential underlying mechanism for cognitive impairment in this population.
  • Larger studies are needed to confirm these findings.

Keywords:
arterial stiffnesscerebrovascular changesdementiaend stage renal diseasesystolic heart function

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