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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Investigation on the Association of Cardiovascular Markers with Severity of Chronic Pyelonephritis
O A Efremova1, L A Kamyshnikova1, S E Veysalov1
1Belgorod State University, Belgorod, Russia.
Insights
Chronic pyelonephritis (CP) significantly impacts cardiovascular health, especially in recurrent or active stages. Cardiovascular markers worsen with comorbid ischemic heart disease in CP patients, highlighting the need for integrated management.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease (CVD).
- Chronic pyelonephritis (CP) is a cause of CKD and can influence cardiovascular comorbidity.
- The interplay between CP progression and cardiovascular markers in ischemic heart disease requires further investigation.
Purpose of the Study:
- To evaluate the association between cardiovascular markers and the course of chronic pyelonephritis (CP).
- To assess the impact of CP on patients with comorbid ischemic heart disease.
- To identify how different phases and recurrence rates of CP affect cardiovascular parameters.
Main Methods:
- 125 patients with CP were categorized into three groups: recurrent (CPr), active (CPa), and inactive (CPi) phases.
- Cardiovascular markers including carotid artery augmentation index (AI %), brachial artery diameter change (D %), and left ventricular ejection fraction (EF) were measured.
- Comparison of cardiovascular parameters across the three CP patient groups.
Main Results:
- Significant cardiovascular system alterations were observed, particularly in patients with comorbid and relapsing CP.
- Patients with active CP and stable coronary artery disease showed distinct AI % and D % values compared to other groups.
- Elevated pulmonary artery diameter, EF, left ventricular pressure and volume, pulse wave velocity, and vascular resistance index were noted in affected CP patients.
Conclusions:
- The course and comorbidity of chronic pyelonephritis significantly influence cardiovascular health.
- Recurrent and active phases of CP are associated with more pronounced negative cardiovascular changes.
- Monitoring cardiovascular markers in CP patients is crucial for managing comorbid conditions like ischemic heart disease.
Abstract:
Chronic kidney disease (CKD) is an established independent risk factor for cardiovascular disease (CVD) and is caused by chronic pyelonephritis (CP). This study aimed to investigate the effect of the association of cardiovascular markers with the course of CP on the comorbidity of CP with ischemic heart disease. The study participants included 125 patients with CP without symptoms of urinary tract obstruction who were divided into three groups. The first group (n=45) consisted of patients with recurrent CP (CPr) three or more times per year. The second group (n=42) included patients with active phase pyelonephritis (CPa), with a frequency of two times or less per year, with concomitant pathology (stable coronary artery disease, functional class I - II), and the third group (n=38) included patients with an inactive phase of the disease (CPi), with a history of pyelonephritis of at least five years. The patients' carotid artery augmentation index (AI %) and the change in the diameter of the brachial artery (D %) in CPi, CPa, and CPr groups were 8.44±1.76, 15.47±4.00, 11.71±1.70, 13.81±3.06, 12.75±2.55 and 6.54±3.27, respectively. The left ventricular ejection fraction (EF) index in the three study groups was estimated to be 68.92±3.76, 64.76±2.75, and 66.28±3.45%, respectively. An analysis of the results showed the most significant changes in the parameters of the cardiovascular system in patients with a comorbid and relapsing course of CP. The results showed a significant increase in pulmonary artery diameter, EF, left ventricular pressure and volume, pulse wave velocity in the aorta, and vascular resistance index.
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