Abstract
Background: Arterial stiffness is the hallmark of the vascular aging process, in which a disruption in collagen to elastin balance in the large arteries with decreased compliance of the central vasculature leads to excess cardiovascular morbidity. Carotid- Femoral Pulse wave velocity (PWV) is the preferred non-invasive way to quantify arterial stiffness. Apart from age, blood pressure, presence of long standing hypertension, diabetes or kidney impairment, inflammation has been quoted as an harbinger of arterial stiffness. However, in a prior work of our group we found Familial Mediterrenean Fever (FMF) patients to have a decreased PWV, possibly relaed to the relapsing-remitting type of the disease and a possible ptotective role of colchicine. Objective: To compare the PWV of patients with Glomerulonephritis (GN) in clinical remission to patients with non inflammatory CKD (either eGFR < 60 or uACR above 30 mg/gram), mostly related to hypertension and diabetes. Methods: We prospectively collected data on 58 patients from our Nephrology and Hypertension Center, which either had non inflammatory CKD (30 patients) or a glomerular disease in partial or complete remission (28 patients). central (aortic) blood pressure and Pulse wave velocity (PWV) were measured using validated Sphygmocor XCEL ® device. Results: In a multivariate regession analysis adjusting for age, presence of hypertension, history of diabetes and creatinine values, having glomerular disease in remission was associated with a significant decrease in PWV (B- 3.262) indicating better arterial elasticity compared to CKD patients. Conclusion: Patients with glomerulonephritis in remission have better arterial elasticity compared to CKD patients, possibly similar to the general age and blood pressure matched population. This is in accordance with our findings in FMF patients, who were adherent to colchicine treatment and in clinical remission. It is possible that prior treatment with anti-inflammatory and immunomodulatory drugs carry a beneficial effect on vascular health.
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