Arterial stiffness and enlargement in mild-to-moderate chronic kidney disease

• Published in: Kidney international Vol. 69; no. 2; pp. 350 - 357
• Main Authors: Briet, M., Bozec, E., Laurent, S., Fassot, C., London, G.M., Jacquot, C., Froissart, M., Houillier, P., Boutouyrie, P.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.2006; Nature Publishing; Elsevier Limited; Nature Publishing Group
• Subjects: Adult; Aged; Aorta - pathology; Aorta - physiopathology; Biological and medical sciences; carotid arteries; Carotid Arteries - pathology; Carotid Arteries - physiopathology; Chronic Disease; Elasticity; Female; Glomerular Filtration Rate; Human health and pathology; Humans; hypertension; Hypertrophy; Kidney - physiopathology; kidney disease; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidneys; Life Sciences; Male; mechanical stresses; Medical sciences; Middle Aged; Multivariate Analysis; Nephrology. Urinary tract diseases; pathology; Tissues and Organs; ultrasonography; Urinary system involvement in other diseases. Miscellaneous; pathology; ultrasonography; mechanical stresses; glomerular filtration rate; kidney disease; carotid arteries; hypertension; Sonography; Hypertension; Kidney disease; Nephrology; Urinary system disease; Glomerular filtration; Rate; Cardiovascular disease; Chronic kidney disease; Artery; Urology; Anatomic pathology; Mechanical stress; Blood vessel; Carotid; Echography; Stiffness; Circulatory system
• DOI: 10.1038/sj.ki.5000047
• ISSN: 0085-2538

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular morbidity and mortality. Arterial stiffness and remodeling have been well documented in patients with end-stage renal disease, but little is known about arterial phenotype in CKD patients with moderate reduction in glomerular filtration rate (GFR). In total, 95 patients (58±15 years, mean±s.d.) with CKD and GFR measured by renal clearance of 51Cr-ethylenediaminetetraacetate were compared to 121 hypertensive patients without CKD (59±11 years), and 57 normotensive subjects (56±6 years). Common carotid artery diameter, intima–media thickness (IMT), distensibility, and Young's elastic modulus were noninvasively determined with a high-definition echotracking system. Patients with CKD had a significantly larger carotid internal diameter than in hypertensives and normotensives (6.32±1.05, 5.84±0.74, and 5.50±0.64 m × 10-3, respectively; P<0.001), resulting in 25% and 11% increases in circumferential wall stress, respectively, since no significant difference in IMT was observed. Carotid distensibility and elastic modulus did not significantly differ between CKD and hypertensives; normotensives had significantly higher distensibility and lower elastic modulus than CKD and hypertensive patients. Carotid-femoral pulse wave velocity was significantly higher in CKD patients than in hypertensives and normotensives. In multivariate analyses either involving the entire population or restricted to CKD patients, GFR was independently and strongly related to carotid diameter and elastic modulus. Arterial enlargement and increased arterial stiffness occur in parallel with the decline in renal function in patients with mild-to-moderate CKD.