The evaluation of arterial stiffness and volume status in chronic kidney disease patients

Aim: Aretrial stiffness has an independent predictive value for cardiovascular events in several populations, including patients with uncomplicated essential hypertension and type II diabetes. There is limited information regarding the prognostic value of arterial stiffness in patients with mild to moderate renal disease. As markers of arterial stiffness; Pulse wave velocity (PWV) and Augmentation index (AIx) are non-invazive methods using to determine the level of vascular injury. In this study, we aimed to study PWV, AIx and volume status of the stage 3 ? 5 CKD and CAPD patients comparing with healthy controls.Methods: Sixty six stage 3 ? 5 CKD patients (without known cardiovascular disease), 21 CAPD patients (treated with CAPD at least 3 months) and 34 healthy controls were included into the study. PWV and AIx were evaluated by the same operator after 15 minutes rest period (Mobil-O-Graph®). Volume status of the patients were evaluated by bioimpedance spectroscopy (BIS) for detection of hypervolemia. Body composition analysis using the BIS technique [50 frequencies (Body Composition Monitor: Fresenius Medical Care, Bad Homburg, Germany)] were performed.Results: Median PWV values was 7.5 m/sn in stage 3 ? 5 CKD patients, 6.2 m/sn in CAPD group, 5.9 m/sn in healthy controls. PWV values were significantly increased in stage 3 ? 5 CKD patients than CAPD and healthy controls (p=0.002). PWV values were not different between CAPD patients and healthy controls. Normalized AIx values (according to heart rate of 75/min) were not different among three groups (p=0.287). Extracellular fluid excess was +1.26 L in stage 3 ? 5 CKD patients, +1.21 L in CAPD patients compared with healthy controls. Overhydration (OH) was more prevalent in in stage 3 ? 5 CKD and CAPD patients (p<0.001). PWV was positively correlated with OH in stage 3 ? 5 CKD patients (p=0.004). PWV was negatively correlated with total protein (p<0.001), albumin (p<0.001) and calcium values (p<0.001) PWV was weakly correlated with OH in CAPD patients. (p=0.021).Conclusion: PWV were find to be increased in stage 3 ? 5 CKD patients. OH may possibly be a contrubuting factor in this increment of PWV.Key Words: PWV, AIx, Arterial stiffness, Chronic kidney disease, Overhydration