The ambulatory arterial stiffness index and target-organ damage in Chinese patients with chronic kidney disease

BMC Nephrology

Tan-Qi Lou¹  Hui Peng¹  Zeng-Chun Ye¹  Xun Liu¹  Wen-Yu Gong¹  Cui-Cui Li¹  Jun Zhang¹  Cheng Wang¹ 

[1] Division of Nephrology, Department of medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China

关键词: Left ventricular mass index;    Renal function;    Chronic kidney disease;    Ambulatory arterial stiffness index;   

Others  :  1082782
DOI  :  10.1186/1471-2369-14-257

 received in 2012-12-04, accepted in 2013-11-07,  发布年份 2013

【 摘 要 】

Background

The ambulatory arterial stiffness index (AASI) can be used to predict cardiovascular morbidity and mortality in hypertensive patients. However, data on AASI in Chinese patients with chronic kidney disease (CKD) is not available.

Methods

This cross-sectional study enrolled 583 CKD patients. Univariate and multivariate analyses were used to evaluate the relationship between AASI and renal function and parameters of cardiovascular injury.

Results

Patients with a higher AASI had a higher systolic blood pressure, a lower estimated glomerular filtration rate (eGFR), a higher serum cystatin C, a higher left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT). Univariate analyses showed that AASI was positively correlated with serum cystatin C (r=0.296, P < 0.001), serum creatinine (r=0.182, P < 0.001), and LVMI (r = 0.205, P < 0.001) and negatively correlated with the eGFR (r = –0.200, P < 0.001). Multivariate analyses revealed that serum cystatin C, eGFR, serum creatinine and LVMI were independently correlated with AASI.

Conclusions

These data suggest that AASI was closely correlated with renal function and parameters of cardiovascular injury in Chinese CKD patients. Good quality, long-term, large longitudinal trials to validate the role of AASI in clinical practice for Chinese CKD patients.

【 授权许可】

   
2013 wang et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Couser WG, Remuzzi G, Mendis S, Tonelli M: The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int 2011, 80:1258-1270.
• [2]Siasos G, Tousoulis D, Michalea S, Oikonomou E, Kolia C, Kioufis S, Synetos A, Vlasis K, Papavassiliou AG, Stefanadis C: Biomarkers determining cardiovascular risk in patients with kidney disease. Curr Med Chem 2012, 19(16):2555-2571.
• [3]Gosse P, Safar ME: Arterial stiffness and plasma creatinine in untreated hypertensive patients. Am J Hypertension 2005, 18:1140-1145.
• [4]Chue CD, Townend JN, Steeds RP, Ferro CJ: Republished paper: arterial stiffness in chronic kidney disease: causes and consequences. Postgrad Med J 2010, 86:560-566.
• [5]Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Li Y, Dolan E, Thijs L, Wang JG, O’Brien E, Ibsen H, Jeppesen J: Ambulatory arterial stiffness index predicts stroke in a general population. J Hypertens 2006, 24:2247-2253.
• [6]Li Y, Wang JG, Dolan E, Gao PJ, Guo HF, Nawrot T, Stanton AV, Zhu DL, O’Brien E, Staessen JA: Ambulatory arterial stiffness index derived from 24-hour ambulatory blood pressure monitoring. Hypertension 2006, 47:359-364.
• [7]Dolan E, Thijs L, Li Y, Atkins N, McCormack P, McClory S, O’Brien E, Staessen JA, Stanton AV: Ambulatory arterial stiffness index as a predictor of cardiovascular mortality in the Dublin outcome study. Hypertension 2006, 47:365-370.
• [8]Kikuya M, Staessen JA, Ohkubo T, Thijs L, Metoki H, Asayama K, Obara T, Inoue R, Li Y, Dolan E, Hoshi H, Hashimoto J, Totsune K, Satoh H, Wang JG, O’Brien E, Imai Y: Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan. Stroke 2007, 38:1161-1166.
• [9]Muxfeldt ES, Cardoso CR, Dias VB, Nascimento AC, Salles GF: Prognostic impact of the ambulatory arterial stiffness index in resistant hypertension. J Hypertens 2010, 28:1547-1553.
• [10]Li Y, Hansen TW, Staessen JA: Ambulatory arterial stiffness index: reproducibility of different definitions. Am J Hypertens 2010, 23:129-134.
• [11]Mulè G, Cottone S, Cusimano P, Incalcaterra F, Giandalia M, Costanzo M, Nardi E, Palermo A, Geraci C, Costa R, Cerasola G: Inverse relationship between ambulatory arterial stiffness index and glomerular filtration rate in arterial hypertension. Am J Hypertens 2008, 21:35-40.
• [12]Leoncini G, Ratto E, Viazzi F, Vaccaro V, Parodi A, Falqui V, Conti N, Tomolillo C, Deferrari G, Pontremoli R: Increased ambulatory arterial stiffness index is associated with target organ damage in primary hypertension. Hypertension 2006, 48:397-403.
• [13]Gómez-Marcos MA, Recio-Rodríguez JI, Patino-Alonso MC, Gómez-Sánchez L, Agudo-Conde C, Gómez-Sánchez M, Rodríguez-Sánchez E, García-Ortiz L, Vasorisk Group: Ambulatory arterialstiffness indices and target organ damage in hypertension. BMC Cardiovasc Disord 2012, 27:12. 1
• [14]Stergiou GS, Kollias A, Giovas PP, Papagiannis J, Roussias LG: Ambulatory arterial stiffness index, pulse pressure and pulse wave velocity in children and adolescents. Hypertens Res 2010, 33:1272-1277.
• [15]Pogue V, Rahman M, Lipkowitz M, Toto R, Miller E, Faulkner M, Rostand S, Hiremath L, Sika M, Kendrick C, Hu B, Greene T, Appel L, Phillips RA, African American Study of Kidney Disease and Hypertension Collaborative Research Group: Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension 2009, 53:20-27.
• [16]Williams JS, Brown SM, Conlin PR: Videos in clinical medicine: blood-pressure measurement. N Engl J Med 2009, 360:e6.
• [17]Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I, et al.: Recommendations for quantification of the left ventricle by two-dimensional echocardiography: American society of echocardiography committee on standards, subcommittee on quantitation of two-dimensional echocardiograms. J Am Soc Echocardiography 1989, 2:358-367.
• [18]Zoccali C, Benedetto FA, Mallamaci F, Tripepi G, Giacone G, Cataliotti A, Seminara G, Stancanelli B, Malatino LS, CREED Investigators: Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis. J Am Soc Nephrol 2001, 12:2768-2774.
• [19]Ommen S, Nishimura R: A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update, 2003. Heart 2003, 89:18-23.
• [20]Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W, Wang M, Xu GB, Wang HY: Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 2006, 17:2937-2944.
• [21]Wang Y, Hu Y, Li Y, Li H, Chu S, Zhu D, Gao P: Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients. Hypertens Res 2012, 35:201-206.
• [22]Kips JG, Vermeersch SJ, Reymond P, Boutouyrie P, Stergiopulos N, Laurent S, Van Bortel LM, Segers P: Ambulatory arterial stiffness index does not accurately assess arterial stiffness. J Hypertens 2012, 30:574-580.
• [23]Laugesen E, Erlandsen M, Knudsen ST, Hansen KW, Poulsen PL: Ambulatory arterial stiffness index: a composite index reflecting arterial stiffness, blood pressure variability and patients’ diurnal cycle. J Hypertens 2011, 29:2278-2279.
• [24]Peres LA, Matsuo T, Delfino VD, Peres CP, Almeida Netto JH, Ann HK, Camargo MT, Rohde NR, Uscocovich VF: Increase in prevalence of diabetes mellitus as a cause of dialytic end-stage renal disease: analysis of 20 years in the west region of Paraná. Arq Bras Endocrinol Metabol 2007, 51:111-115.
• [25]USRDS annual data report. 2012.
• [26]Van Eps CL, Jeffriess L, Haluska B, Hawley CM, Coombes J, Matsumoto A, Jeffries JK, Johnson DW, Campbell SB, Isbel NM, Mudge DW, Marwick T: Cardiac and vascular structure and function parameters do not improve with alternate nightly home hemodialysis: An interventional cohort study. BMC Nephrol 2011, 12:51-65. BioMed Central Full Text
• [27]Zhang L, Zhao F, Yang Y, Qi L, Zhang B, Wang F, Wang S, Liu L, Wang H: Associations between carotid artery intima-media thickness and cardiovascular risk factors in CKD. Am J Kidney Dis 2005, 46:856-862.
• [28]Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H: European network for non-invasive investigation of large arteries: expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006, 27:2588-2605.
• [29]Kunitoshi I, Yoshiharu I, Chiho I, et al.: Proteinuria and the risk of developing end-stage renal disease. Kidney Int 2003, 63:1468-1474.
• [30]Agarwal R: Antihypertensive agents and arterial stiffness: relevance to reducing cardiovascular risk in the chronic kidney disease patient. Curr Opin Nephrol Hypertens 2007, 16:409-415.
• [31]Mulè G, Cottone S, Cusimano P, Palermo A, Geraci C, Nardi E, Castiglia A, Costanzo M, Cerasola G: Unfavourable interaction of microalbuminuria and mildly reduced creatinine clearance on aortic stiffness in essential hypertension. Int J Cardiol 2010, 145:372-375.
• [32]Robles NR, Mena C, Macias R, Garcia de Vinuesa E, Herrera J, Macias JF: Symmetrical ambulatory arterial stiffness index: relationship with microalbuminuria and renal function. Eur J Int Med 2010, 21:118-122.
• [33]Upadhyay A, Hwang SJ, Mitchell GF, Vasan RS, Vita JA, Stantchev PI, Meigs JB, Larson MG, Levy D, Benjamin EJ: Fox CS: arterial stiffness in mild-to-moderate CKD. J Am Soc Nephrol 2009, 20:2044-2053.