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Updated: May 14, 2026

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

Pulse Wave Velocity, Mortality and Cardiovascular Disease in Chronic Kidney Disease: A Systematic Review and

Carlos Pascual-Morena1,2, Silvana Patiño-Cardona1, Miriam Garrido-Miguel1,2

  • 1Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain.

European Journal of Clinical Investigation
|May 13, 2026
PubMed

Insights

Increased pulse wave velocity (PWV) in chronic kidney disease (CKD) patients is linked to higher risks of death and cardiovascular disease (CVD). Further research is needed to confirm these findings due to current evidence limitations.

Area of Science:

  • Cardiology
  • Nephrology
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) significantly elevates cardiovascular morbidity and mortality.
  • Arterial stiffness, indicated by pulse wave velocity (PWV), is a key mediator of cardiovascular complications in CKD.
  • PWV indices (aortic, brachial-ankle, carotid-radial) and estimated PWV (ePWV) are potential predictors of adverse outcomes in CKD.

Purpose of the Study:

  • To systematically analyze the association between various PWV measures and all-cause mortality, cardiovascular mortality, and cardiovascular disease (CVD) risk in CKD populations.
  • To synthesize evidence from observational studies using meta-analysis to quantify the predictive value of PWV for clinical events in CKD.

Main Methods:

  • A comprehensive systematic search of PubMed, Scopus, and Web of Science was performed.
  • Included observational studies estimated the association between PWV (categorical or per 1 m/s increase) and mortality/CVD risk.
  • Random-effects meta-analyses were conducted, stratifying by PWV type, and results were reported as hazard ratios (HR) with 95% confidence intervals (95% CI).

Main Results:

  • Twenty-eight studies were included in the review, with 22 contributing to meta-analyses.
  • A 1 m/s increase in aortic PWV (aPWV) was associated with significantly higher risks: HR 1.16 (1.06-1.28) for all-cause mortality, HR 1.36 (1.15-1.61) for cardiovascular mortality, and HR 1.20 (1.02-1.41) for CVD risk.
  • Categorical associations and results for brachial-ankle PWV (baPWV) and estimated PWV (ePWV) also indicated increased risks, though specific values varied.

Conclusions:

  • Elevated PWV is demonstrably associated with increased mortality and CVD risk in individuals with CKD.
  • The current evidence base supporting these associations is of low quality.
  • More high-quality, rigorous studies are essential to validate the clinical utility of PWV measurements in managing CKD patients.
Abstract

Keywords:
Haemodialysisend‐stage renal diseaseepidemiologyprognosisrisk stratificationvascular ageing

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