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Updated: Jul 30, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Comparison between central and automated peripheral blood pressure measurement for early detection of kidney
Ahmed Abdel-Galeel1, Nader N Fawzy2, Wageeh A Ali3
1Cardiovascular Medicine Department, Assiut University Heart Hospital, Assiut University, Assiut, Egypt. ahmed.galeel@aun.edu.eg.
Insights
Central blood pressure measurement is more effective than peripheral measurement for predicting kidney disease. Arterial stiffness parameters, like augmentation index and pulse wave velocity, correlate with reduced kidney function.
Area of Science:
- Cardiology
- Nephrology
- Biomedical Engineering
Background:
- Blood pressure is linked to cardiovascular events, stroke, and kidney disease.
- Traditional mercury sphygmomanometers are being replaced by newer methods.
- Central blood pressure measurement offers superior prediction of cardiovascular events compared to peripheral measurement.
Purpose of the Study:
- To compare central and peripheral blood pressure measurements in patients with and without chronic kidney disease.
- To assess the utility of arterial stiffness parameters in predicting renal impairment.
Main Methods:
- 201 patients with primary hypertension were studied.
- Blood pressure was measured using OMRON M2 and Mobil-O-Graph devices.
- Kidney function and abdominal ultrasonography were performed.
Main Results:
- Patients with chronic kidney disease were older and had longer hypertension duration.
- Central blood pressure measurements were lower than automated peripheral measurements.
- Arterial stiffness parameters (augmentation index, pulse wave velocity) were higher in patients with chronic kidney disease and correlated negatively with estimated glomerular filtration rate.
Conclusions:
- Central and peripheral blood pressure measurements show agreement in diagnosing hypertension.
- Non-invasive central blood pressure measurements are preferred for early detection of renal impairment.
- Arterial stiffness parameters are valuable for predicting chronic kidney disease.
Background:
There is a close relationship between blood pressure levels and the risk of cardiovascular events, strokes, and kidney disease. For many years, the gold standard instrument for blood pressure measurement was a mercury sphygmomanometer and a stethoscope, but this century-old technique of Riva-Rocci/Korotkov is being progressively removed from clinical practice. Central blood pressure is considered better than peripheral blood pressure in predicting cardiovascular events, as it assesses wave reflections and viscoelastic properties of the arterial wall which make systolic and pulse pressures vary from central to peripheral arteries, but mean blood pressure is constant in the conduit arteries.
Methods:
The study included 201 patients with primary hypertension (108 patients with chronic kidney disease and 93 patients without kidney disease). All patients underwent blood pressure measurement by OMRON M2 and Mobil-O-Graph devices, kidney function assessment and abdominal ultrasonography.
Results:
Patients with chronic kidney disease were significantly older (60.02 ± 9.1 vs. 55.33 ± 8.5; P < 0.001), with longer duration of hypertension (7.56 ± 5.9 vs. 6.05 ± 5.8; P = 0.020) in comparison to those without chronic kidney disease. Automated peripheral measurement of systolic blood pressure, diastolic blood pressure and pulse pressure were significantly higher in comparison to central blood pressure. Patients with chronic kidney disease had significantly higher augmentation index (24.06 ± 12.6 vs. 19.02 ± 10.8; P < 0.001) and pulsed wave velocity (8.66 ± 1.5 vs. 8.69 ± 6.8; P = 0.004) in comparison to those without chronic kidney disease. Augmentation index had positive correlation with pulse wave velocity (r = 0.183, P = 0.005). There was negative correlation between both pulse wave velocity and augmentation index and estimated glomerular filtration rate (r = -0.318, P < 0.001), and (r = -0.236, P < 0.001), respectively. Hence, arterial stiffness parameters are good positive test for prediction of chronic kidney disease.
Conclusion:
There is a strong agreement between non-invasive centrally and automated peripherally measured blood pressure in diagnosis of hypertension. But non-invasive central measurements are preferred over automated measurements for early prediction and detection of renal impairment.
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