Korean J Intern Med.  2013 Jul;28(4):464-474. 10.3904/kjim.2013.28.4.464.

Accelerated progression of arterial stiffness in dialysis patients compared with the general population

• Avramovski P
• Janakievska P
• Sotiroski
• Sikole A

• KMID: 1503784
• DOI: http://doi.org/10.3904/kjim.2013.28.4.464

Abstract

BACKGROUND/AIMS
The aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression.
METHODS
The study group included 80 patients undergoing hemodialysis (aged 59.3 +/- 11.8 years; duration of dialysis 5.47 +/- 5.16 years). The control group consisted of 60 patients (aged 57.5 +/- 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m2. Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures.
RESULTS
The mean PWV values at baseline and 36 months were 11.18 +/- 2.29 and 11.82 +/- 2.34 m/sec in the CHP group, and 9.02 +/- 1.89 and 9.29 +/- 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 +/- 18.373 cm/sec in CHP and 27.28 +/- 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient beta [betast] = -0.405, p = 0.004; betast = -0.364, p = 0.011), albumin (betast = -0.349, p = 0.042; betast = -0.303, p = 0.034), CRP (betast = 0.458, p = 0.002; betast = 0.187, p = 0.008), and total cholesterol (betast = 0.236, p = 0.038; betast = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively.
CONCLUSIONS
Accelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.

Keyword

Vascular stiffness; Arteriosclerosis; Pulse wave velocity; Renal dialysis

MeSH Terms

Aged
Arteries/metabolism/*physiopathology/ultrasonography
Biological Markers/blood
Case-Control Studies
Disease Progression
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Pulse Wave Analysis
Renal Dialysis/*adverse effects
Risk Factors
Time Factors
Ultrasonography, Doppler
Vascular Diseases/blood/diagnosis/*etiology/physiopathology
*Vascular Stiffness
Biological Markers