Relationship between acceleration plethysmography and aortic calcification index in chronic kidney disease patients

Abstract

It has been reported that acceleration plethysmography (APG) that is a noninvasive and very simple method for the assessment of arterial stiffness. The objectives of the present study were to evaluate usefulness of APG and to compare the data on blood pressure (BP), serum biochemistry, and aortic calcification index (ACI) in chronic kidney disease (CKD) patients. ACI, systolic BP, diastolic BP, and serum biochemistry values were obtained from 35 hemodialysis (HD group) patients, 15 peritoneal dialysis (PD group) patients and 20 nondialysis patients (CKD Stages 1–5; nondialysis group). After APG, the acceleration plethysmogram aging index (APG-AI) was calculated. Aortic calcification was measured semiquantitatively using computed tomography (CT) images of the abdominal aorta, and then ACI was calculated. Phosphate (PO 4 ) and calcium×phosphate product (Ca×PO 4 ) in the HD or PD groups were significantly higher than those in the nondialysis group. APG-AI and ACI, which are used for evaluation of arteriosclerosis, in HD or PD groups were higher compared with the nondialysis group. APG-AI and ACI increased with aging. APG-AI was significantly correlated with ACI. APG-AI and ACI in the HD and PD groups were more advanced than in the nondialysis group. Aortic calcification in the HD and PD groups was affected by high levels of P and Ca×PO 4 . There was a significant correlation between APG, a functional evaluation of arteriosclerosis, and ACI, a morphological evaluation. Therefore, it appears that APG might provide valuable information on arteriosclerosis in CKD patients. 背景: 對於動脈硬化程度的評估，加速度體積描記法(acceleration plethysmography, APG)是一個很簡單的非侵入性方法。本研究在慢性腎病(CKD)患者間進行了APG測量，並與血壓(BP)、血清生化學、及主動脈鈣化指數(ACI)作出比較。 方法: 我們分別在35位血液透析患者(HD組)、15位腹膜透析患者(PD組)、及20位非透析之1-5期CKD患者(非透析組)間，收集了ACI、收縮壓(SBP)、舒張壓(DBP)、及血清生化學數據，亦在APG後算得相關的老化指數(APG-AI)。主動脈鈣化則採半量化方式，透過腹部主動脈的電腦斷層攝影算得ACI。 結果: 相比於非透析組，HD組及PD組的磷(P)及鈣磷乘積(Ca×P)明顯較高；動脈硬化指標APG-AI與ACI亦是以HD組及PD組明顯高於非透析組。APG-AI及ACI隨著年齡增加，其中APG-AI與ACI呈明顯相關性。 結論: 相比於非透析組，HD組及PD組具較晚期的APG-AI與ACI數值，兩組的主動脈鈣化受到P與Ca×P偏高影響。在動脈硬化程度的評估中，功能(APG)與形態(ACI)明顯相關。因此，APG可望為CKD患者的動脈硬化發展提供有用的資訊。