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June 27, 2026American Journal of Nephrology

Higher PWV linked to ~13% greater CVD risk and increased mortality in dialysis patients.

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Why the study?

There is a great burden of CSVD in the dialysis population, and arterial stiffness is an important risk factor, but its effect on CSVD and related clinical consequences remains to be clarified.

Does arterial stiffness assessed by pulse wave velocity predict cerebral small vessel disease, cognitive decline, cardiovascular events, and mortality in maintenance dialysis adults?

Population

178 maintenance dialysis adults

Comparison

Pulse wave velocity levels

Design

Prospective cohort study

Follow-up

Up to 10 years

Key result

In adults on maintenance dialysis, higher pulse wave velocity was associated with increased risks of cardiovascular disease (HR 1.13; 95% CI 1.08-1.18) and all-cause mortality.

Authors

LSLin ShiKZKe ZhengYQYujun Qian

Discussion

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Overview

Higher PWV may flag elevated CSVD risk in dialysis; leaves open whether stiffness reduction improves cognition, CVD, or survival.

Key Points

  • This research aims to explore the relationship between arterial stiffness assessed by PWV and its impact on cerebral small vessel disease, cognitive decline, cardiovascular disease, and mortality in dialysis patients.
  • Prospective cohort study involving 178 maintenance dialysis adults
  • Assessment of cerebral small vessel disease through microbleeds, lacunae, and white matter hyperintensity
  • Analysis included multivariate regression and Cox proportional hazards model for 10 years of follow-up.
  • Frequency of cerebral microbleeds was 32.6%, lacunae 25.3%, and white matter hyperintensity 34.8%.
  • PWV linked to increased risk of lacunae (OR 1.11, 95% CI 1.02-1.20) and WMH (OR 1.11, 95% CI 1.02-1.20).
  • In follow-up, PWV associated with CVD (HR 1.13, 95% CI 1.08-1.18) and all-cause mortality (HR 1.11, 95% CI 1.06-1.16).

Study Design

Type

Cohort (n=178)

Structured PICO

Does arterial stiffness assessed by pulse wave velocity predict cerebral small vessel disease, cognitive decline, cardiovascular events, and mortality in maintenance dialysis adults?

P
Population
178 adults on maintenance dialysis followed for up to 10 years to assess the impact of arterial stiffness on cardiovascular and cognitive outcomes.
E
Exposure
Arterial stiffness assessed by pulse wave velocity (PWV) using sequential recording of electrocardiogram-gated carotid and femoral artery pressure waves
O
Outcome
Cerebral small-vessel disease (cerebral microbleed, lacunae, and white matter hyperintensity), cognitive impairment, cardiovascular disease, and all-cause mortality up to 10 years follow-uphard clinical

Main Result

Hazard Ratio: 1.13 (95% CI 1.08–1.18)

In maintenance dialysis patients, increased arterial stiffness measured by pulse wave velocity is an independent predictor of long-term cardiovascular disease and all-cause mortality.

Cite This Study

Shi et al. (2026) conducted a cohort in Maintenance dialysis (n=178). Pulse wave velocity (PWV) was evaluated on Cardiovascular disease (CVD) (HR 1.13, 95% CI 1.08-1.18). In adults on maintenance dialysis, higher pulse wave velocity was associated with increased risks of cardiovascular disease (HR 1.13; 95% CI 1.08-1.18) and all-cause mortality.

synapsesocial.com/papers/6a3f69caaea7db3c195408eehttps://doi.org/10.1159/000553205
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association of non-invasive measures of subclinical atherosclerosis and arterial stiffness with mortality and major cardiovascular events in chronic kidney disease: systematic review and meta-analysis of cohort studies2019 · 40 citations
  2. 2Aortic Stiffness, Cerebrovascular Dysfunction, and Memory2016 · 64 citations
  3. 3The Predictive Value of Atherogenic Index of Plasma, Non- High Density Lipoprotein Cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, and Lipoprotein Combine Index for Stroke Incidence and Prognosis in Maintenance Hemodialysis Patients2024 · 17 citations
  4. 4Aortic Stiffness and White Matter Microstructural Integrity Assessed by Diffusion Tensor Imaging: The ARIC‐NCS2020 · 26 citations
  5. 5Effect of ultrafiltration on cerebral small-vessel disease and related outcomes in hemodialysis2023 · 7 citations