title: Accelerated progression of arterial stiffness in dialysis patients compared with the general population.
abstract: OBJECTIVE
  The aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression.
  
  
  METHODS
  The study group included 80 patients undergoing hemodialysis (aged 59.3 ± 11.8 years; duration of dialysis 5.47 ± 5.16 years). The control group consisted of 60 patients (aged 57.5 ± 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m(2). Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures.
  
  
  RESULTS
  The mean PWV values at baseline and 36 months were 11.18 ± 2.29 and 11.82 ± 2.34 m/sec in the CHP group, and 9.02 ± 1.89 and 9.29 ± 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 ± 18.373 cm/sec in CHP and 27.28 ± 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient β [βst] = -0.405, p = 0.004; βst = -0.364, p = 0.011), albumin (βst = -0.349, p = 0.042; βst = -0.303, p = 0.034), CRP (βst = 0.458, p = 0.002; βst = 0.187, p = 0.008), and total cholesterol (βst = 0.236, p = 0.038; βst = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively.
  
  
  CONCLUSIONS
  Accelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.
authors.affiliation: Department of Internal Medicine and Hemodialysis, JZU Clinical Hospital Dr Trifun Panovski, Bitola, Republic of Macedonia. avramovski@gmail.com
authors.forename: Petar
authors.initials: P
authors.lastname: Avramovski
authors.forename: Pavlina
authors.initials: P
authors.lastname: Janakievska
authors.forename: Kosta
authors.initials: K
authors.lastname: Sotiroski
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sikole
mesh_terms: D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers
keywords: Arteriosclerosis; Pulse wave velocity; Renal dialysis; Vascular stiffness