PP.18.12

Abstract

Objective: Cardiovascular (CV) diseases are the first mortality cause in patients with chronic kidney disease (CKD). Among several CV risk factors, vascular stiffness takes a primary role in those patients, and it seems essential to evaluate the arterial conditions in these subjects in order to better understand their CV risk. The aim of our study was to explore the relationship between arterial stiffness, evaluated using Pulse Wave Velocity (PWV), arteriolar narrowing of retinal vessels by the non-mydriatic digital fundus oculi examination and cardiac damage as Left Ventricular Hypertrophy (LVH) or remodeling by echocardiographic evaluation. Design and method: We studied 65 patients with CKD stage 2–4 NKF-KDOQI (mean age 69,12 ± 6,43, mean eGFR 32 ± 1,5 ml/min), after physical examination, anthropometric and biochemical measurements, every patient underwent office and 24 h ambulatory blood pressure (BP) and 2D color Doppler echocardiography. According to the presence (Group A) or the absence (Group B) of echocardiographic LV geometric alterations they were divided in two groups (LVH and LVR as defined in the current ESH guidelines). Then femoral PWV was measured by applanation tonometry to evaluate the big vessels damage and retinal study was performed to investigate the early retinal vessel changes. The obtained vessel images were analysed by a dedicated software, commonly used to calculate arteriolar-venular ratio (AVR) index of arteriolar narrowing. Results: Group A (34 patients) and B (31 patients) showed similar values of serum Creatinine (2.76 vs. 2.39 mg/dL, p = 0.25) 24 h systolic BP (132,4 vs. 133,2 mmHg, p = 0,65), diastolic BP (73 vs. 81 mmHg, p = 0.18), mean BP (95 vs. 99 mmHg, p = 0.7). and AVR (0,76 vs. 0,77 p = 0,51) Moreover, cfPWV resulted significantly higher in Group A than in Group B (15,245 vs 11.06 m/s p = 0.0002). Conclusions: Our study shows that in patients with CKD, cfPWV is correlated with LV geometric alterations. cfPWV is a standardized, reproducible and easy to obtain marker of large artery stiffening, and can be measured noninvasively. In these patients, in order to better stratificate CV risk, the evaluation of large and small vessels damage is useful and easy to perform.