Determinants of Progression of Aortic Stiffness in Hemodialysis Patients

  • Mihai S. Utescu
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Véronique Couture
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Fabrice Mac-Way
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Sacha A. De Serres
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Karine Marquis
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Richard Larivière
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Simon Desmeules
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Marcel Lebel
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Pierre Boutouyrie
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...
  • Mohsen Agharazii
    From the CHU de Québec Research Center, L’Hôtel Dieu de Québec Hospital Quebec, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Division of Nephrology, Faculty of Medicine, Université Laval, Quebec, Canada (M.S., V.C., F.M.-W., S.A.D.S., K.M., R.L., S.D., M.L., M.A.); Université Paris Descartes, Paris, France (P.B.); Department of Pharmacology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France (P.B.); and Institut National de la...

書誌事項

タイトル別名
  • A Prospective Longitudinal Study

抄録

<jats:p> Aortic stiffness is associated with increased cardiovascular mortality in patients with chronic kidney disease. However, the rate of progression of arterial stiffness and the role of cardiovascular risk factors in the progression of arterial stiffness has never been established in a longitudinal study. In a prospective, longitudinal, observational study, carotid-femoral pulse wave velocity and carotid-radial pulse wave velocity were assessed in 109 hemodialysis patients at baseline and after a mean follow-up of 1.2 years. We examined the impact of age, atherosclerotic cardiovascular disease, diabetes mellitus, dialysis vintage, and pentosidine (a well-characterized, advanced glycation end products) on the rate of progression of aortic stiffness. The annual rate of changes in carotid-femoral pulse wave velocity and carotid-radial pulse wave velocity were 0.84 m/s per year (95% confidence interval, 0.50–1.12 m/s per year) and −0.66 m/s per year (95% confidence interval, −0.85 to −0.47 m/s per year), respectively. Older subjects, and patients with diabetes mellitus or atherosclerotic cardiovascular disease had higher aortic stiffness at baseline, however, the rate of progression of aortic stiffness was only determined by plasma pentosidine levels ( <jats:italic>P</jats:italic> =0.001). The degree of baseline aortic stiffness was a significant determinant of the regression of brachial stiffness ( <jats:italic>P</jats:italic> <0.001) suggesting that the regression of brachial stiffness occurs in response to central aortic stiffness. These findings suggest that traditional cardiovascular risk factors may play some role in the progression of aortic stiffness before development of advanced chronic kidney disease, and that the enhanced rate of progression of aortic stiffness in chronic kidney disease patients on dialysis are probably determined by more specific chronic kidney disease–related risk factors such as advanced-glycation end products. </jats:p>

収録刊行物

  • Hypertension

    Hypertension 62 (1), 154-160, 2013-07

    Ovid Technologies (Wolters Kluwer Health)

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