Aortic pulse wave velocity in haemodialysis patients is associated with the prescription of active vitamin D analogues.
BACKGROUND
Cardiovascular disease remains the most common cause of death for haemodialysis patients. In addition to traditional cardiovascular risk factors, haemodialysis patients have additional risk factors, including vascular calcification. Pulse wave velocity (PWV) is a measurement of arterial stiffness, and we wished to determine whether PWV is affected by different factors in haemodialysis patients compared to the general population.


METHODS
Aortic PWV was measured in 303 adult patients attending for routine outpatient dialysis.


RESULTS
303 patients, 63.4% male, mean age 68.5 ± 15.8 years, 47.5% diabetic with a body mass index of 25.8 ± 5.3 kg/m(2), were studied. Systolic blood pressure (SBP) was 148.7 ± 28.6 mmHg and diastolic 80.4 ± 15.3 mmHg. Aortic PWV was 9.73 ± 2.08 m/s, and was correlated with SBP (β 0.015, F 5.29, p = 0.023), log serum parathyroid hormone (PTH) (β 1.58, F 13.85, p < 0.001) and prescription of alfacalcidol (β -1.11, F 6.81, p = 0.010). 197 patients had corresponding ECHO cardiograms, and in this cohort PWV was associated with SBP (β 0.017, F 7.49, p = 0.006), log serum parathyroid hormone (β 0.85, F 5.99, p < 0.015) and prescription of alfacalcidol (β -0.8, F 4.18, p = 0.042), left ventricular mass index (LVMI) (β 0.01, F 11.4, p = 0.001), and log serum triglycerides (β 1.43, F 4.79, p = 0.03).


CONCLUSIONS
We found that PWV, a measurement of arterial stiffness, was associated with both traditional cardiovascular risk factors, including SBP and LVMI, but also non-traditional risk factors such as prescription of active vitamin D analogues, suggesting a potential link between vascular calcification and arterial stiffness in haemodialysis patients.
UCL Centre for Nephrology, Royal Free Hospital, University College London Medical School, Rowland Hill Street, London, NW3 2PF, UK, evacharitaki@hotmail.com.
Evangelina
E
Charitaki
Andrew
A
Davenport
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology*; D011307:Drug Prescriptions; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D059289:Vascular Stiffness / Q000187:drug effects*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D014280:Triglycerides; D014807:Vitamin D; C008088:alfacalcidol