Factors associated with vascular stiffness: cross-sectional analysis from the Chronic Renal Insufficiency Standards Implementation Study.
BACKGROUND
Vascular stiffness is associated with increased cardiovascular risk. This study aimed to identify factors associated with vascular stiffness in a cohort of chronic kidney disease (CKD) patients.


METHODS
The Chronic Renal Insufficiency Standards Implementation Study is a prospective epidemiological study of CKD patients not on dialysis, who are managed in a clinic setting. Phenotypic parameters were collected annually, and vascular stiffness was assessed using augmentation index (AI). Cross-sectional analysis was performed across quintiles of AI to evaluate factors associated with vascular stiffness.


RESULTS
Mean patient age was 66.1 +/- 14.1 years and estimated glomerular filtration rate (eGFR) was 31.2 +/- 5.7 ml/min. Corrected calcium was 2.26 +/- 0.2 SD mmol/l, phosphate 1.2 +/- 0.4 SD mmol/l and intact parathyroid hormone 94 +/- 96 SD pg/ml; 18.3% of patients had cardiovascular disease. Increased age and systolic blood pressure were associated with increased AI (all p < 0.001). No statistical association was present between AI and eGFR, intact parathyroid hormone, phosphate or protein excretion.


CONCLUSIONS
This study identified blood pressure as a potentially modifiable risk factor associated with AI, whereas eGFR was not associated with increased AI in a population of CKD stage 3-5 patients. Further knowledge of factors which influence progression of vascular stiffness will be important in risk quantification and management.
Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
Helen
H
Eddington
Smeeta
S
Sinha
Elizabeth
E
Li
Janet
J
Hegarty
Jeanette
J
Ting
Beverley
B
Lane
Constantina
C
Chrysochou
Robert
R
Foley
Donal
D
O'Donoghue
Philip A
PA
Kalra
Rachel
R
Middleton
D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D014655:Vascular Resistance