Original investigationsPathogenesis and treatment of kidney disease and hypertensionStepwise increase in arterial stiffness corresponding with the stages of chronic kidney disease
Section snippets
Patients
In this cross-sectional study, 121 patients with CKD who received medical treatment and follow-up from September 2003 to May 2004 at National Cheng Kung University Hospital in Tainan, Taiwan, were evaluated. The diagnosis and classification of CKD were established according to criteria from the Clinical Practice Guidelines for Chronic Kidney Disease from the National Kidney Foundation–Kidney Disease Outcomes Quality Initiative.25 Estimated glomerular filtration rate (GFR) was derived from the
Results
Hypertension, dyslipidemia, the presence of 2 or more traditional cardiovascular risk factors, and any high risk were shown by more than half the total series of patients. Compared with subjects with CKD stages 1 to 2, patients with CKD stages 3 to 4 and stage 5 were older and had a greater prevalence of CVD, DM, and hypertension and higher systolic BP, PP, and PWV. Significant differences were found in age, hypertension, estimated GFR per 1.73 m2, systolic BP, pulse pressure (PP), and PWV
Discussion
Atherosclerosis, a primary intimal disease characterized by the presence of plaques and occlusive lesions, is preceded by endothelial injury and dysfunction and may begin early in life, especially in patients with CKD. Increased arterial stiffness and decreased compliance are the major alterations in conduit function, which can be evaluated noninvasively by measuring the PWV of large arteries.27, 28 Mourad et al24 reported a significant negative association between PWV and creatinine clearance
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2021, Heart Lung and CirculationCitation Excerpt :Accordingly, it has been hypothesised that moderately decreased renal function may be the cause of increased AS. It was also suggested that central AS may be an important pathophysiologic phenotype of vascular disease in CKD [24–27]. Several other mechanisms might be involved, including endothelial dysfunction, activation of the renin-angiotensin system (RAS), and qualitative and quantitative changes in the arterial wall such as glycation end-products, lipid peroxidation, elastin fragmentation, vascular smooth muscle cell hyperplasia, increased collagen, and decreased number of elastic fibres.
Originally published online as doi:10.1053/j.ajkd.2004.11.011 on January 14, 2005.
Supported in part by grant no. NSC92-2314-B-006-064 from the National Science Council, Taipei, Taiwan.