Arterial Stiffness in Patients with Non-Diabetic Chronic Kidney Disease (CKD)

BACKGROUND: Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular disease (CVD). Arterial stiffness plays an important role in the pathogenesis of CVD; however, to date, there have been no reports of the assessment of arterial stiffness in patients at different stages of non-diabetic CKD. METHODS: We studied 50 patients with non-diabetic CKD (stages 1-5, 5D) receiving medical treatment at Tokyo Women's Medical University. Pulse wave velocity (PWV) was assessed using an applanation tonometer to determine arterial compliance. All current medications were recorded and biochemical parameters were analyzed. RESULTS: Non-diabetic CKD stage 5D patients had a higher PWV, and higher serum levels of C-reactive protein (CRP), Ca, P and intact parathyroid hormone (iPTH) than non-diabetic CKD stage 1-5 patients (p=0.03, p=0.009, p=0.006, p=0.00005, and p=0.002, respectably). As compared to non-diabetic CKD stage 1-2 patients, patients with non-diabetic CKD stage 3-5 were older, and had higher serum levels of P and iPTH and a higher PWV (p=0.0002, p=0.009, p=0.03, and p=0.004). Nephrosclerosis was associated with a higher PWV, higher serum levels of CRP, and a higher prevalence of CVD than patients with CKD of other origins. CONCLUSION: We showed a stepwise increase of arterial stiffness with increasing disease severity stage in patients with CKD not associated with diabetes mellitus. CKD caused by nephrosclerosis was found to be associated with increased arterial stiffness and to be a risk factor for CVD.