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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

16.4K

The arterial stiffness changes in hemodialysis patients with chronic kidney disease: The impact on mortality

Konrad Rekucki1, Agnieszka Sławuta2, Dorota Zyśko3

  • 1Department of Cardiology, T. Marciniak Lower Silesian Specialist Hospital, Wrocław, Poland.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
|April 8, 2022
PubMed

Insights

Arterial stiffness in kidney disease patients predicts mortality. A paradoxical increase in arterial compliance (AC) independently increases mid-term mortality risk in hemodialysis patients.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Biomedical Engineering

Background:

  • Patients with kidney disease face elevated cardiovascular risks from known and novel factors.
  • Arterial stiffness is an emerging cardiovascular risk factor requiring further investigation.
  • High-resolution echo-tracking offers a developing method for assessing local arterial stiffness.

Purpose of the Study:

  • To evaluate carotid arterial stiffness in long-term hemodialysis (HD) patients using high-resolution echo-tracking.
  • To determine the association between arterial stiffness and mid-term mortality in this patient cohort.

Main Methods:

  • Fifty-eight hemodialysis patients underwent clinical assessment, laboratory tests, and carotid stiffness measurements (beta stiffness index, Young's modulus, arterial compliance, pulse wave velocity) before and after dialysis.
  • Changes in arterial stiffness parameters (Δ) were calculated.
  • Survival analysis was conducted over 48 months using Cox proportional hazard regression.

Main Results:

  • After 48 months, 25 of 58 patients died. Deceased patients were older and had more coronary artery disease.
  • Significantly higher ΔAC (arterial compliance change) was observed in non-survivors.
  • Mortality was significantly associated with age, PCI history, LVEF, ΔAC, glucose, total protein, and post-HD sodium and pre-HD potassium levels.

Conclusions:

  • Echo-tracking assessment of arterial stiffness provides valuable clinical insights into mid-term mortality risk in chronic kidney disease (CKD) patients.
  • A paradoxical increase in arterial compliance (AC) is an independent predictor of mid-term mortality in maintenance hemodialysis patients.
  • Understanding the complex interplay of vascular, hemodynamic, and sympathetic factors in kidney failure is crucial.
Abstract

Keywords:
arterial stiffnesschronic kidney diseaseecho-trackinghemodialysismortality

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