Abstract
BackgroundCardiovascular events are seen more frequently after the age of 60 and they are a significant cause of morbidity and mortality. Arterial stiffness is a property that can be expressed by pulse wave velocity and this value is assumed to be a predictor of cardiovascular events. Patients with chronic kidney disease and dysregulated blood sugar have increased atherosclerosis and arterial stiffness, but the relationship between physiological levels of Hba1c and arterial stiffness is less clear in chronic kidney disease patients without diabetes mellitus.ObjectivesHere, we aimed to investigate the degree of arterial stiffness among non-diabetic, non-dialysis dependent chronic kidney disease patients with physiological HbA1c levels.MethodsWe enrolled 51 patients who were followed up at Ege University Hospital Nephrology Department between February and June 2015. Non-diabetic, non-dialysis dependent chronic kidney disease patients were included in the study. Blood pressure and pulse wave velocity were measured with an applanation tonometry device (Sphygmocor Vx Software Atcor Medical, Australia). Correlations between pulse wave velocity and the aforementioned parameters were investigated (see below).ResultsWe detected a significant correlation between pulse wave velocity and systolic blood pressure (p=0.0001) and Hba1c (p=0.044) separately. There was an inverse correlation with creatinine clearance (p=0.04). We also detected a significant correlation with serum phosphorus level (p=0.0077) and furosemide use (p=0.014). No correlations were found among the other parameters.ConclusionsArterial stiffness is an important predictor of cardiovascular events and measuring it is an inexpensive method for estimating morbidity and mortality. Our study supports the importance of measuring arterial stiffness and of controlling blood glucose levels, even at physiological Hba1c values, especially for chronic kidney disease patients.
Highlights
Arterial stiffness (AS) refers to the rigidity of arterial vessels and is the result of a multifactorial process with extensive vascular calcifications in chronic kidney disease.[1]
That atherosclerosis accelerates the effect of dysregulated blood sugar among chronic kidney disease (CKD) patients has been well demonstrated in clinical trials, but this is less clear among patients without diabetes.[4,6]
Seventeen percent of 51 patients had previously-known coronary arterial disease and 3% had peripheral arterial disease. When they were classified according to the causes of CKD; it was determined that 19.6% of the cases had glomerulonephritis, 15.6% had tubulointerstitial nephritis and drugrelated causes, 17.6% had hypertension (HT), 13.7% had urolithiasis, and 5.8% had polycystic kidney disease
Summary
Arterial stiffness (AS) refers to the rigidity of arterial vessels and is the result of a multifactorial process with extensive vascular calcifications in chronic kidney disease.[1]. Arterial stiffness is a property that can be expressed by pulse wave velocity and this value is assumed to be a predictor of cardiovascular events. Objectives: Here, we aimed to investigate the degree of arterial stiffness among non-diabetic, non-dialysis dependent chronic kidney disease patients with physiological HbA1c levels. Non-diabetic, non-dialysis dependent chronic kidney disease patients were included in the study. Results: We detected a significant correlation between pulse wave velocity and systolic blood pressure (p=0.0001) and Hba1c (p=0.044) separately. Conclusions: Arterial stiffness is an important predictor of cardiovascular events and measuring it is an inexpensive method for estimating morbidity and mortality. Our study supports the importance of measuring arterial stiffness and of controlling blood glucose levels, even at physiological Hba1c values, especially for chronic kidney disease patients
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