Changes and influential factors of carotid-femoral pulse wave velocity in patients with chronic kidney disease

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Abstract

BACKGROUND:

Little data have been available concerning function features of arterial elasticity in patients with chronic kidney disease at 2-5 stage not undergoing dialysis. Studies have demonstrated that carotid-femoral pulse wave velocity (PWVcf) can be used to evaluate arterial elasticity.

OBJECTIVE:

To explore the changes and influential factors of PWVcf in patients with chronic kidney disease.

DESIGN, TIME AND SETTING:

A non-randomized controlled experiment was performed at the Department of Nephrology, Peking University Third Hospital from January to August 2006.

PARTICIPANTS:

166 patients with chronic kidney disease and 28 health persons were selected from Peking University Third Hospital.

METHODS:

The patients were divided into 3 groups based on the Kidney/Dialysis Outcomes Quality Initiative (K/DOQI) guideline for chronic kidney disease: mild group (at stage 1 to 2), moderate group (at stage 3) and severe group (at stage 4 to 5); the healthy people served as control. Body mass, blood pressure, PWVcf and biochemical indicators were determined to calculate glomerular filtration rate and compare the differences. One-way and multiple regression analyses were used to explore related factors of PWVcf.

MAIN OUTCOME MEASURES:

PWVcf and influential factors.

RESULTS:

Compared with control group, the patients had significantly higher levels of systolic blood pressure, diastolic blood pressure, pulse pressure and PWVcf (P < 0.05). There was no difference in terms of age, body height, body mass, and body mass index. The patients with mild, moderate and severe kidney disease displayed differences in age, body mass index, glomerular filtration rate, systolic blood pressure, and pulse pressure. With severity of disease, PWVcf was significantly increased, and age, systolic blood pressure, and pulse pressure were also increased, but body mass index and glomerular filtration rate was decreased. Besides gender factor (r = 2.305, P < 0.05), PWVcf was significantly positively correlated with age (r = 0.479, P < 0.001), systolic blood pressure (r = 0.556, P < 0.001), pulse pressure (r=0.603, P < 0.001), serum creatinine (r = 0.287, P < 0.001) and C-reactive protein (r =0.316, P < 0. 001), but negatively correlated with glomerular filtration rate (r = -0.436, P < 0.001). Stepwise multiple regression analysis demonstrated that age and glomerular filtration rate were independently related with PWVcf.

CONCLUSION:

PWVcf in patients with chronic kidney disease was aggravated with severity of kidney injury; glomerular filtration rate and age were independent factors of arteriosclerosis in patients with chronic kidney disease.

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