Declining renal function may cause premature arterial aging with loss of the reservoir function and exacerbation of wave motions. Recently, the reservoir wave analysis (RWA) was developed to construct the reservoir pressure (Preservoir) and a pressure due to wave motions (Pexcess). We aimed to investigate the parameters derived from RWA in different stages of chronic kidney disease (CKD).Design and Method:
Carotid pressure waveforms and aortic flow waveforms were recorded using tonometry and Doppler echocardiography respectively in a cohort of 99 CKD patients. RWA was performed from the calibrated pressure and flow waveforms to generate 6 parameters, namely peak of Preservoir (Max), pulse pressure of Preservoir (PPR), Pexcess integral (XSPI), Preservoir integral (PRI), systolic rate constant (SC) and diastolic rate constant (DC). Arterial stiffness was assessed using carotid-femoral pulse wave velocity (PWV) measured by arterial tonometry.Results:
There were no significant differences in brachial blood pressures or PWV among patients with different stages of CKD. Conversely, increasing PPR, XSPI, PRI and DC were associated with more advanced stages of CKD (trend P values: PPR = 0.040, XSPI = 0.011, PRI = 0.034, and DC = 0.014). The dose-response trend persisted with further adjustments for sex, and mean arterial blood pressure (trend P values: PPR = 0.001, XSPI = 0.003, PRI = 0.008 and DC = 0.021).Conclusions:
Parameters derived from RWA may be useful to characterize the premature arterial aging process associated with the deteriorated renal function.