title: Relationship between aortic pulse wave velocity, selected proinflammatory cytokines, and vascular calcification parameters in peritoneal dialysis patients.
abstract: BACKGROUND
  Vascular calcification and arterial stiffening are cardiovascular risk factors among chronic kidney disease patients. Elevated aortic pulse wave velocity (AoPWV) is an independent predictor of increased cardiovascular morbidity and mortality.
  
  
  OBJECTIVE
  The aim of the study was to analyze the relationships between inflammatory and vascular calcification parameters and arterial wall stiffness in chronic kidney disease (CKD) patients treated by peritoneal dialysis.
  
  
  METHODS
  The study included 57 patients (27 women and 30 men) aged from 19 to 75 years (mean age 53 ± 13), treated by peritoneal dialysis during 4-100 months (mean 30.4 months). The concentrations of albumin, lipids, interleukin-6 (IL-6), IL-18, high-sensitive C-reactive protein, transforming growth factor-β1 (TGF-β1), osteocalcin, osteoprotegerin (OPG), fibroblast growth factor 23, fetuin A, parathyroid hormone (iPTH), total calcium (Ca), and phosphates (Pi) were measured. AoPWV was performed using a tonometric method, common carotid artery intima-media thickness (CCA-IMT) by ultrasonography evaluation, and calcium scoring (CaSc) with multirow spiral computed tomography (MSCT).
  
  
  RESULTS
  In univariate analysis, AoPWV correlated negatively with osteocalcin (R = -0.37; P = 0.005) and positively with OPG (R = 0.41; P = 0.002). Additionally, AoPWV was significantly positively associated with inflammatory parameters: IL-6 (R = 0.35; P = 0.009), TGF-β1 (R = 0.27; P = 0.047), and white blood cell (WBC) count (R = 0.33; P = 0.01). There were also positive correlations between AoPWV and imaging data: CCA-IMT (R = 0.32; P = 0.02) and CaSc (R = 0.38; P = 0.004). AoPWV did not correlate with calcium, phosphate, Ca × Pi index, or iPTH concentration. After multiple adjustments, osteocalcin was the only significant predictor of AoPWV. In logistic regression adjusted for age, hypertension, and mean arterial pressure at AoPWV evaluation, only osteocalcin was significantly associated with high (above median) AoPWV values [odds ratio 0.96 (0.92-0.99) per unit increase in osteocalcin].
  
  
  CONCLUSIONS
  OPG concentration and some inflammatory markers (WBC count, IL-6, TGF-β1) influenced the severity of arterial wall stiffness in CKD patients. Measurement of osteocalcin seems to be the best predictor of AoPWV.
authors.affiliation: aDepartment of Nephrology bDepartment of Medical Diagnostics cDepartment of Internal Medicine and Gerontology dDepartment of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Cracow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Krzanowski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Janda
authors.forename: Paulina
authors.initials: P
authors.lastname: Dumnicka
authors.forename: Marzena
authors.initials: M
authors.lastname: Dubiel
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Stompór
authors.forename: Beata
authors.initials: B
authors.lastname: Kuśnierz-Cabala
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzicki
authors.forename: Władysław
authors.initials: W
authors.lastname: Sułowicz
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001808:Blood Vessels / Q000473:pathology*; D002114:Calcinosis; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D063177:Pulse Wave Analysis
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators