The Relationship between Central Arterial Stiffness and Aortic Calcification in a Cross-Sectional Study of Patients Undergoing Hemodialysis

Jung, An Doc; Kim, Chang Seong; Choi, Joon Seok; Bae, Eun Hui; Kim, Kye Hun; Ahn, Young Keun; Kim, Soo Wan

Abstract

BACKGROUND/AIMS
Cardiovascular (CV) disease is the leading cause of death in patients with chronic kidney disease. It may be related to nontraditional risk factors such as arterial stiffness (AS) and vascular calcification (VC). AS, as evaluated by pulse wave velocity (PWV), has been established to be an independent predictor of CV mortality. This study investigated the relationship between AS and VC, and contributing risk factors in patients with hypertension undergoing hemodialysis (HD).
METHODS
Cross-sectional data are reported on 65 patients with hypertension and 61 patients undergoing HD. PWV, abdominal computed tomography (CT) scans, and serum markers of mineral metabolism were measured.
RESULTS
Mean heart-femoral (hf) PWV and brachial-ankle (ba) PWV were higher in the HD group than in the hypertensive group. In a univariate linear regression analysis, hfPWV was positively correlated with age (r = 0.613, p < 0.01), pulse pressure (r = 0.540, p < 0.01), highest aortic VC (HU) (r = 0.483, p < 0.01), gender (r = 0.354, p < 0.05), and diabetes (r = 0.331, p < 0.05). Aortic VC was also positively correlated with pulse pressure (r = 0.483, p < 0.01), age (r = 0.392, p < 0.01), and dialysis duration (r = 0.389, p < 0.05). In a multivariate regression analysis, old age, diabetes, male gender, high pulse pressure, and dialysis duration were significantly associated with PWV in that order, whereas high pulse pressure, dialysis duration, and age were significant factors for aortic VC. Arterial stiffness was more prevalent and advanced in the diabetic HD group than that in the nondiabetic HD group.
CONCLUSIONS
A high prevalence of arterial stiffness was noted in patients undergoing HD, which was closely related with old age, diabetes, male gender, and high pulse pressure. Patients with diabetes undergoing HD may be at risk for vascular stiffness.