CAROTID-FEMORAL PULSE WAVE VELOCITY, PULSE WAVE ANALYSIS AND 24-HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract

Objective: Increased arterial stiffness and arterial hypertension are known risk factors for vascular damage and are an independent predictor of cardiovascular events. Pulse wave analysis of the radial artery (PWA) is a simple method for assessing various hemodynamic parameters in the central aorta. The aim of our study was to investigate the relationship between arterial stiffness measured by carotid femoral pulse wave velocity (cfPWV), PWA parameters and 24-hour ambulatory blood pressure measurement (ABPM) in patients with chronic kidney disease (CKD). Design and method: We conducted a cross-sectional study in a cohort of 87 non-dialysed CKD patients. cfPWV and PWA were investigated non-invasively using applanation tonometry (SphygmoCor®,Atcor, Australia). ABPM was measured with the monitor BR -102 (Schiller, Switzerland). Cardiovascular (CV) risk factors (urinary albumin/creatinine ratio, NT -pro-BNP, troponin I, cystatin C, cholesterol, LDL, HDL, triglycerides, lipoprotein Lp(a)) were measured. The patients were divided into two groups according to the median cfPWV: lower cfPWV group (cfPWV < 11.58m/s, n = 44), higher cfPWV group (cfPWV > 11.58m/s, n = 43). Results: The mean age of the patients was 60 ± 13.4 years, 65.5% were men, 24.1% had diabetes, 43.7% were smokers. Further descriptive data for all patients and both groups are presented in Table 1. With the t-test we found a significant difference between both groups regarding age (P < 0.0001), but not regarding the biochemical CV risk factors. Patients with higher cfPWV had statistically significant higher central aortic systolic pressure (P < 0.0001) and pulse pressure (P < 0.0001), lower subendocardial viability ratio (P = 0.003), higher 24 h systolic ABPM (P < 0.0001) and 24 h pulse pressure (P < 0.0001). Conclusions: The results of our study show that non-dialysis CKD patients with higher cfPWV levels also have higher systolic and pulse pressure (central aorta and 24 h ABPM).