Increased aortic wall stiffness associated with low circulating fetuin A and high C-reactive protein in predialysis patients.
OBJECTIVE
Vascular calcification and arterial stiffening are cardiovascular risk factors among chronic kidney disease (CKD) patients. The aim of the study was to analyze relationships between inflammatory markers, fetuin A and arterial wall stiffness in CKD patients in the predialysis period and on maintenance dialysis.


METHODS
Serum C-reactive protein (hs-CRP), fetuin A, interleukin 6 (IL-6) and other classical markers of atherosclerosis were measured in a group of 155 CKD patients (77 on hemodialysis, HD, 29 on peritoneal dialysis, 49 in CKD stage 5 in the predialysis period) and in 30 healthy volunteers. The aortic pulse wave velocity (aoPWV) was recorded using a tonometric method.


RESULTS
The aoPWV, serum hs-CRP and IL-6 were higher and fetuin A levels were lower in all CKD groups than in controls. In multiple regression analysis, the age appeared as the strongest, independent factor increasing arterial wall stiffness in all investigated groups, including controls, whereas the association of aoPWV with IL-6 and fetuin A remained significant only in HD patients.


CONCLUSIONS
Aortic wall stiffness is higher in CKD patients than in controls, and it already develops in the predialysis period. Age is the principal determinant of arterial wall stiffness also in CKD patients. The acceleration of arterial wall stiffness in CKD is associated with additional factors, i.e. fetuin A deficiency and higher CRP and IL-6.
Porazko
Tomasz
T
Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
Kuźniar
Jakub
J
Kusztal
Mariusz
M
Kuźniar
Tomasz J
TJ
Weyde
Wacław
W
Kuriata-Kordek
Magdalena
M
Klinger
Marian
M
D001011:Aorta / Q000503:physiopathology*; D001798:Blood Proteins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein