Qualification of arterial stiffness as a risk factor to the progression of chronic kidney diseases.
BACKGROUND
Reflection pressure may influence the clinical course of chronic kidney diseases (CKDs). The relationship between the augmentation index (AI) and progression of non-diabetic CKDs was characterized.


METHODS
Ninety-nine patients were enrolled into the study. Pulse wave form analysis was performed to determine AI that assesses arterial stiffness.


RESULTS
In a cross-sectional study, a multiple regression analysis found that AI correlated positively to age and weight, and negatively to height and heart rate (R(2) = 0.50). Furthermore, echocardiography was performed in 51 patients who gave their consent. In male patients under angiotensin inhibition, left ventricular mass index increased as AI was elevated (r = 0.33, slope = 0.85 +/- 0.30 g/m(2)/%, p < 0.05, n = 23). A prospective study was performed in 41 patients who consented to having their creatinine clearance measured repeatedly. In the patients with angiotensin inhibition a higher basal AI resulted in a greater annual decrease in creatinine clearance (r = -0.52, slope = -0.43 +/- 0.14 ml/min/year/%, p < 0.01, n = 27).


CONCLUSIONS
The present data indicate that AI as well as angiotensin contribute to the development of left ventricular hypertrophy. Furthermore, our results suggest that in addition to angiotensin, AI is a risk factor of progression of non-diabetic CKDs.
Takenaka
Tsuneo
T
Department of Nephrology, Saitama Medical College, 38 Moro-hongo Moroyama, Iruma Saitama 350-0495, Japan.
Mimura
Taku
T
Kanno
Yoshihiko
Y
Suzuki
Hiromichi
H
D000809:Angiotensins / Q000037:antagonists & inhibitors; D001158:Arteries / Q000503:physiopathology*; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000503:physiopathology; D002908:Chronic Disease; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004452:Echocardiography; D004548:Elasticity; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors
D000809:Angiotensins; D003404:Creatinine