Impaired renal function impacts negatively on vascular stiffness in patients with coronary artery disease.
BACKGROUND
Chronic kidney disease (CKD) and coronary artery disease (CAD) are independently associated with increased vascular stiffness. We examined whether renal function contributes to vascular stiffness independently of CAD status.


METHODS
We studied 160 patients with CAD and 169 subjects without CAD. The 4-variable MDRD formula was used to estimate glomerular filtration rate (eGFR); impaired renal function was defined as eGFR <60 mL/min. Carotid-femoral pulse wave velocity (PWV) was measured with the SphygmoCor® device. Circulating biomarkers were assessed in plasma using xMAP® multiplexing technology.


RESULTS
Patients with CAD and impaired renal function had greater PWV compared to those with CAD and normal renal function (10.2 [9.1;11.2] vs 7.3 [6.9;7.7] m/s; P < 0.001). In all patients, PWV was a function of eGFR (β = -0.293; P < 0.001) even after adjustment for age, sex, systolic blood pressure, body mass index and presence or absence of CAD. Patients with CAD and impaired renal function had higher levels of adhesion and inflammatory molecules including E-selectin and osteopontin (all P < 0.05) compared to those with CAD alone, but had similar levels of markers of oxidative stress.


CONCLUSIONS
Renal function is a determinant of vascular stiffness even in patients with severe atherosclerotic disease. This was paralleled by differences in markers of cell adhesion and inflammation. Increased vascular stiffness may therefore be linked to inflammatory remodeling of the vasculature in people with impaired renal function, irrespective of concomitant atherosclerotic disease.
Sabrina H
SH
Rossi
Emily P
EP
McQuarrie
William H
WH
Miller
Ruth M
RM
Mackenzie
Jane A
JA
Dymott
María U
MU
Moreno
Chiara
C
Taurino
Ashley M
AM
Miller
Ulf
U
Neisius
Geoffrey A
GA
Berg
Zivile
Z
Valuckiene
Jonathan A
JA
Hannay
Anna F
AF
Dominiczak
Christian
C
Delles
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D063177:Pulse Wave Analysis / Q000379:methods; D059289:Vascular Stiffness / Q000502:physiology*
D015415:Biomarkers; D018836:Inflammation Mediators