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Published on: February 7, 2014
Association of brachial-ankle pulse wave velocity with cognitive impairment in peritoneal dialysis patients
Chunyan Yi1, Wenbo Zhang2, Hongjian Ye1
1Department of Nephrology,The First Affiliated Hospital, Sun Yat-sen University and Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, PR China.
Insights
Higher arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), is linked to cognitive impairment (CI) in peritoneal dialysis (PD) patients. This finding highlights a potential cardiovascular risk factor for cognitive decline in this population.
Area of Science:
- Nephrology
- Cardiology
- Neurology
- Vascular Medicine
Background:
- The interplay between cognitive impairment (CI) and arterial stiffness in patients undergoing peritoneal dialysis (PD) remains incompletely understood.
- Arterial stiffness is a known cardiovascular risk factor, and its association with CI in the general population is established, but not specifically in PD patients.
Purpose of the Study:
- To investigate the relationship between cognitive function and arterial stiffness in patients receiving peritoneal dialysis.
- To determine if markers of arterial stiffness can predict cognitive impairment in PD patients.
Main Methods:
- A cross-sectional study involving 643 PD patients in China.
- Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA).
- Arterial stiffness was evaluated using a vascular profiler, measuring indicators like brachial-ankle pulse wave velocity (baPWV).
Main Results:
- Nearly half (49.9%) of the enrolled PD patients exhibited cognitive impairment.
- Patients with CI demonstrated significantly higher baPWV, systolic blood pressure, and pulse pressure compared to those with normal cognitive function.
- Brachial-ankle pulse wave velocity (baPWV) showed superior predictive performance for CI compared to other vascular parameters.
Conclusions:
- Elevated baPWV is independently associated with cognitive impairment in peritoneal dialysis patients.
- Arterial stiffness, particularly baPWV, may serve as a valuable indicator for cognitive decline in PD patients.
Background:
The relationship between cognitive impairment (CI) and arterial stiffness in peritoneal dialysis (PD) patients has not been clearly clarified. The aim of this study was to examine the relationship between CI and arterial stiffness in PD patients.
Methods:
This cross-sectional study enrolled PD patients who performed a vascular profiler test at a single PD center in China between January 2014 and June 2016. The cognitive function was evaluated using the Montreal cognitive assessment (MoCA). A noninvasive vascular screening device was used to assess arterial stiffness relevant indicators.
Results:
A total of 643 PD patients with median age 45 (37-57.4) years and median duration of PD 27.8 (8.7-56.4) months were enrolled. The rate of CI was 49.9%. The mean brachial-ankle pulse wave velocity (baPWV) was 17.2 ± 5.6 m/s. Compared with normal cognitive function group, patients with CI had higher baPWV (18.6 ± 7.0 vs. 15.8 ± 3.2 m/s), systolic blood pressure (150.3 ± 21.5 vs. 144.2 ± 20.2 mmHg), and pulse pressure (59.7 ± 14.7 vs. 52.5 ± 11.6 mmHg), and lower ankle-brachial index (ABI, 1.12 ± 0.12 vs. 1.15 ± 0.09) (all p<.05). Compared with systolic blood pressure, pulse pressure, and ABI in receiver operating characteristic (ROC) analysis, baPWV had better performance in predicting CI (area under curve: 0.68, 95% confidence interval: 0.64-0.72). BaPWV was independently associated with MoCA score (B per SD, -0.42 [95% confidence interval, -0.71 to -0.12]; p = .006) and CI (OR per SD, 1.55 [95% confidence interval, 1.11-2.17]; p = .011) in PD patients after adjustment for confounders.
Conclusions:
Higher baPWV was independently associated with CI in PD patients.
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