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Updated: Jul 5, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Quantifying carotid stiffness in chronic kidney disease using ultrafast ultrasound imaging
Hui Huang1, Zhengqiu Zhu1, Han Wang2
1Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
Insights
Ultrafast pulse wave velocity (ufPWV) can assess carotid stiffness in chronic kidney disease (CKD) patients. Pulse wave velocity at the end of systole (PWV-ES) shows strong correlation with age, particularly in early CKD stages.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) significantly increases the risk of atherosclerotic cardiovascular events.
- Current renal function indicators often lack sensitivity in early CKD stages, necessitating better atherosclerosis markers.
- Ultrafast pulse wave velocity (ufPWV) offers a non-invasive method to assess carotid stiffness and early atherosclerosis.
Purpose of the Study:
- To investigate the association between carotid stiffness, measured by ufPWV, and renal function in CKD patients.
- To explore the utility of ufPWV as an early indicator of atherosclerosis in CKD.
- To determine the correlation of carotid stiffness parameters with CKD stage and cardiovascular risk factors.
Main Methods:
- A cross-sectional study involving 582 participants, including controls and patients with early (stages 1-2) and advanced (stages 3-5) CKD.
- Carotid intima-media thickness (cIMT) and pulse wave velocities (PWV-BS, PWV-ES) were measured using ultrasound.
- Statistical analyses included ANOVA, LSD tests, and Pearson's correlation to assess relationships between ultrasound parameters, CKD stage, and risk factors.
Main Results:
- Both PWV-BS and PWV-ES were significantly elevated in early and advanced CKD groups compared to controls (P<0.05).
- PWV-ES demonstrated the strongest correlation with age (r=0.474, P<0.001).
- The increase in PWV-ES with age was most pronounced in the early CKD group (r=0.698, P<0.001).
Conclusions:
- ufPWV is a viable tool for quantitatively assessing carotid stiffness in CKD patients.
- PWV-ES may serve as a more sensitive marker for evaluating carotid atherosclerosis in the early stages of CKD.
- These findings highlight the potential of ufPWV in early atherosclerosis detection among CKD populations.
Background:
The mortality and disability of chronic kidney disease (CKD) are highly linked to the incidence of atherosclerotic cardiovascular events. Numerous clinical biochemical indicators of renal function often only increase in advanced stages of CKD, driving an urgent need for reliable indicators of atherosclerosis in early CKD. Ultrafast pulse wave velocity (ufPWV) can evaluate the stiffness of the straight carotid in vivo and quantitatively reflect the degree of early atherosclerosis. However, the use of ufPWV in CKD has not yet been reported. In this study, we aimed to explore the association between carotid stiffness, quantified using ufPWV, and renal function in CKD patients.
Methods:
This cross-sectional study enrolled a total of 582 participants between March 2017 and May 2022 in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. Among those, 205 individuals without a history of CKD and estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2 were included as controls. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI) expert group of the American Kidney Foundation staging for CKD, 44 stages 1 and 2 CKD patients were included in the early CKD group, whereas 49 stages 3, 4, and 5 CKD patients were included in the advanced CKD group. Clinical and serum parameters, ultrasonic characteristics including carotid intima-media thickness (cIMT), and pulse wave velocity at the beginning of systole (PWV-BS) and pulse wave velocity at the end of systole (PWV-ES) of systole were analyzed. One-way analysis of variance (ANOVA) and least significant difference (LSD) tests were performed to compare cIMT, PWV-BS, and PWV-ES among subgroups in pairs. Pearson's correlation analysis, scatter plots, and subgroups correlation analysis were used to determine the relationships among ultrasound characteristics (cIMT, PWV-BS, PWV-ES), and major cardiovascular risk factors.
Results:
PWV-BS and PWV-ES for the early and advanced CKD groups were significantly higher than those for controls (all P<0.05). PWV-ES had the greatest correlation with age (r=0.474, P<0.001). PWV-ES had the greatest increase with age in the early CKD group (r=0.698, P<0.001).
Conclusions:
ufPWV can be used for the quantitative evaluation of carotid stiffness in CKD patients. PWV-ES may be more advantageous in the assessment of carotid atherosclerosis in early CKD patients.
