Key result
Vascular or diabetic renal failure is linked to ~29% lower arterial distensibility versus other causes.
Why the study?
Few studies have focused on the determinants of increased arterial stiffness in patients with renal failure, particularly in relation to the etiology of kidney disease.
Observational (n=117)
Absolute Event Rate: 11% vs 15.4%
p-value: p=<0.05
In patients with renal failure, age, mean arterial pressure, and serum calcium are independent predictors of arterial stiffness, while the etiology of renal disease is an independent predictor only in younger patients.
May guide stiffness risk assessment in renal failure; observational data leave open etiology's age-specific role pending prospective studies.
BACKGROUND: An increased stiffness of the arterial system is an adverse risk factor for the outcome in patients with renal disease. Few studies have focused on the determinants of an increased arterial stiffness in patients with renal failure. As the percentage of patients with renal failure secondary to vascular disease and/or diabetes mellitus is rapidly growing, and the underlying disease per se may also influence the arterial wall properties, it may also be of interest to study the arterial wall properties in relation to the etiology of kidney disease. METHODS: The distensibility coefficient (DC) of the common carotid artery was used as a marker of arterial stiffness. One hundred and seventeen patients were studied: 47 patients (aged 63 +/- 10 years) with renal failure secondary to vascular disease and/or diabetes mellitus and 70 patients (aged 57 +/- 13 years) with other diagnoses. The origin of the renal failure was retrieved from the patients' charts. RESULTS: Age, mean arterial pressure, and serum calcium level were each independent predictors of arterial stiffness (DC). The DC was significantly lower in the patients with vascular renal disease or diabetes mellitus [11.0 +/- 5.5 (1/MPa)] as compared with patients with renal/urological diseases [15.4 +/- 7.5 (1/MPa)]. Nevertheless, after correction for potentially confounding variables, the relation between cause of renal disease and DC lost significance in the overall group, but remained significant (p < 0.05) in the younger age groups (</=61 years; median age of the patient group). CONCLUSIONS: Age, mean arterial pressure, and serum calcium level were independent predictors of arterial stiffness in our patients with renal failure. Only in younger dialysis patients, the origin of renal failure was an independent predictor of arterial wall stiffness.
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Beerenhout et al. (2003) conducted an observational in Renal failure (n=117). Renal failure secondary to vascular disease and/or diabetes mellitus vs. Renal failure secondary to other diagnoses was evaluated on Distensibility coefficient (DC) of the common carotid artery (p=<0.05). Renal failure secondary to vascular disease or diabetes was associated with lower arterial distensibility (11.0 vs 15.4 1/MPa) compared to other etiologies, remaining independent only in younger patients (P<0.05).
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