title: Interrelationship between brachial artery function and renal small artery sclerosis in chronic kidney disease.
abstract: Chronic kidney disease (CKD), characterized by senile inflammation, is a risk factor for cardiovascular disease. Conduit artery function and small artery structure relate to cardiovascular disease. We examined the correlations, determinants and interrelationships of arterial indices in association with CKD in a cross-sectional study of 139 patients (60% male; mean age 44 years) with CKD (stages 3-5, 39%) who underwent a renal biopsy. Conduit artery function and small artery sclerosis were assessed by brachial artery flow-mediated dilatation (FMD) and semiquantitative evaluation of small artery intimal thickening (SA-IT), respectively. The estimated glomerular filtration rate correlated with FMD (r=0.31, P=0.0002) and inversely correlated with SA-IT (r=-0.54, P<0.0001). Multiple regression analysis showed that FMD was inversely correlated with SA-IT and vice versa. In addition, high-sensitivity C-reactive protein (hs-CRP) was significantly correlated with SA-IT, but not FMD. Multiple logistic analysis revealed that higher hs-CRP concomitant with decreased FMD was further associated with the risk of severe SA-IT compared with their individual effects. These findings suggest that both conduit artery and small artery disease develop with mutual interaction in parallel with decreased kidney function. Coexistence of inflammation and conduit artery dysfunction may be closely related to renal small artery sclerosis in patients with CKD.
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Miyagi
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kohagura
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishiki
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Kochi
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kinjyo
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Kinjyo
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Maehara
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakima
authors.affiliation: Dialysis Unit, University Hospital of the Ryukyus, Nishihara-cho, Japan.
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology / Q000503:physiopathology*; D001916:Brachial Artery / Q000473:pathology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000473:pathology / Q000503:physiopathology*; D012598:Sclerosis / Q000503:physiopathology; D014664:Vasodilation / Q000502:physiology; D055815:Young Adult