Age-independent association between arterial and bone remodeling in mild-to-moderate chronic kidney disease.
BACKGROUND
Damages to large arteries are related to bone disease in end-stage renal disease and contribute to cardiovascular mortality. An outward remodeling and stiffening of carotid artery already exist at an earlier stage of chronic kidney disease (CKD). We made the hypothesis that bone disease could be associated with the carotid outward remodeling in parallel with the decline of renal function in this population.


METHODS
One hundred and seven patients (60.4 +/- 14.6 years) with CKD (mean glomerular filtration rate = 34 +/- 17 mL/min/1.73 m(2)) were included in this cross-sectional study. Common carotid artery diameter, intima-media thickness and carotid stiffness were determined with an echotracking system. Bone evaluation was performed by bone densitometry and the measurement of a bone-remodeling marker, bone-specific alkaline phosphatase (BSALP).


RESULTS
After adjustment for age, sex, mean blood pressure, carotid pulse pressure and glomerular filtration rate, bone mineral densities measured at the radius, hip and lumbar spine were significantly and negatively correlated with carotid internal diameter (P = 0.0001, P = 0.0003, P = 0.01, respectively). This association exists only in patients with glomerular filtration rate < or =38 mL/min/ 1.73 m(2). BSALP was independently and positively correlated with carotid internal diameter and explained 13% of the variance.


CONCLUSIONS
Bone mineral density and serum marker of bone remodeling are independently correlated with arterial remodeling in CKD patients suggesting a crosstalk between kidney, arterial wall and bone.
Briet
Marie
M
Université Paris Descartes, INSERM, UMR872, Paris, France. mariebriet1@free.fr
Maruani
Gérard
G
Collin
Cédric
C
Bozec
Erwan
E
Gauci
Cédric
C
Boutouyrie
Pierre
P
Houillier
Pascal
P
Laurent
Stéphane
S
Froissart
Marc
M
D000368:Aged; D000375:Aging / Q000502:physiology*; D015519:Bone Density / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology*; D002339:Carotid Arteries / Q000503:physiopathology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004548:Elasticity / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index