Brachial-ankle pulse wave velocity predicts silent cerebrovascular diseases in patients with end-stage renal diseases.
OBJECTIVE
Cerebrovascular disease (CVD) is a major determinant of the prognosis in end-stage renal diseases (ESRD). The purpose of this study was to examine whether factors associated with arterial stiffness contributed to the development of CVD in patients with ESRD.


METHODS
CVD (lacunes and carotid/intracranial artery stenosis) was evaluated with brain magnetic resonance imaging (MRI), and carotid/intracranial artery magnetic resonance angiography (MRA) in 44 pre-dialytic patients. The severity of CVD was evaluated by the number of lacunes and the degree of stenosis, respectively. The association between CVD and atherosclerotic parameters was evaluated.


RESULTS
Patients with severe lacunes (n=18) manifested older age, lower diastolic blood pressure, serum creatinine and albumin, and higher CRP and serum calcium than those with absent-moderate lacunes (n=26). When assessed by multivariate analysis, only baPWV was adopted as an independent risk factor for severe lacunes. Furthermore, baPWV and i-PTH were associated with the severity of carotid/intracranial artery stenosis, both of which were independent of other risk factors, including age and diabetes.


CONCLUSIONS
Arterial stiffness may constitute a novel determinant predicting the severity of CVD in pre-dialytic patients besides classical risk factors.
Washida
Naoki
N
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan. washida@sc.itc.keio.ac.jp
Wakino
Shu
S
Hayashi
Koichi
K
Kuwahara
Takashi
T
Itoh
Hiroshi
H
D000368:Aged; D001794:Blood Pressure; D001916:Brachial Artery / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis*; D003251:Constriction, Pathologic / Q000473:pathology; D003956:Dialysis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011674:Pulse; D012307:Risk Factors; D013577:Syndrome