title: Pulse wave velocity and vascular calcification at different stages of chronic kidney disease.
abstract: BACKGROUND
  Increased arterial stiffness and vascular calcification have been recognized as important predictors of cardiovascular mortality in patients with chronic kidney disease.
  
  
  METHODS
  In order to examine the precise temporal link between aortic stiffness and cardiovascular risk at the earliest stages of chronic kidney disease, we studied a cohort of 150 patients with chronic kidney disease (52 stage 2/3 patients, 51 stage 4/5 patients and 47 stage 5D patients). Each patient underwent a plain, lateral lumbar radiograph and an abdominal and thoracic multislice spiral computer tomography scan in order to identify and quantify aortic and coronary calcifications. Pulse wave velocity was used as a measure of arterial stiffness.
  
  
  RESULTS
  Regardless of the disease stage, patients with chronic kidney disease had higher adjusted pulse wave velocity than controls with preserved renal function (14.6 +/- 3.8 vs. 10.7 +/- 1.7 m/s, respectively; P < 0.0001). Regarding aortic calcification, there was a gradual but significant rise in later chronic kidney disease stages. A similar trend was found for coronary calcification. In a multivariate analysis only age, mean arterial pressure, diabetes and the aortic calcification score were independent determinants of higher pulse wave velocity.
  
  
  CONCLUSIONS
  We found that both vascular stiffness and vascular calcification appear early in patients with chronic kidney disease, but only vascular calcification worsens as the disease progresses. The increase of vascular stiffness in adult patients with chronic kidney disease seems to be more related to age, systolic blood pressure, diabetes and vascular calcification than to uremic toxicity.
authors.affiliation: INSERM, ERI-12 (EA 4292), Amiens University Medical Center, Jules Verne University of Picardy, Amiens, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Temmar
authors.forename: Sophie
authors.initials: S
authors.lastname: Liabeuf
authors.forename: Cédric
authors.initials: C
authors.lastname: Renard
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.forename: Najeh El
authors.initials: NE
authors.lastname: Esper
authors.forename: Irina
authors.initials: I
authors.lastname: Shahapuni
authors.forename: Claire
authors.initials: C
authors.lastname: Presne
authors.forename: Raifah
authors.initials: R
authors.lastname: Makdassi
authors.forename: Michel
authors.initials: M
authors.lastname: Andrejak
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.forename: Michel E
authors.initials: ME
authors.lastname: Safar
authors.forename: Gabriel
authors.initials: G
authors.lastname: Choukroun
authors.forename: Ziad
authors.initials: Z
authors.lastname: Massy
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001775:Blood Circulation / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D011673:Pulsatile Flow / Q000502:physiology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014655:Vascular Resistance