title: Relationship between vascular function indexes, renal arteriolosclerosis, and renal clinical outcomes in chronic kidney disease.
abstract: OBJECTIVE
  Hypertension contributes critically to the development of renal arteriolosclerosis in chronic kidney disease (CKD), but the impact of vascular function indexes including central blood pressure on renal arteriolosclerosis has not been investigated. We determined whether vascular function indexes were related to renal arteriolosclerosis and renal clinical outcomes in CKD.
  
  
  METHODS
  This cross-sectional study was implemented in our hospital. Subjects were in-patients with CKD aged ≥20 years who underwent a renal biopsy. Vascular function indexes included central systolic blood pressure (SBP), cardio-ankle vascular index (CAVI), and renal resistive index. Central SBP was measured non-invasively using an automated device. Arteriolosclerosis was assessed histologically. Renal clinical outcomes included estimated glomerular filtration rate using serum creatinine (eGFRcreat) or cystatin C (eGFRcys), and the urinary albumin-creatinine ratio.
  
  
  RESULTS
  Among vascular function indexes, central SBP was weakly correlated with renal arteriolosclerosis (n = 55). Renal arteriolosclerosis was increased in hypertensive or hyperuricaemic patients, and negatively correlated with serum high-density lipoprotein (HDL) cholesterol and eGFRcys, which were independent risk factors for renal arteriolosclerosis in a stepwise multivariate regression analysis. Of the vascular function indexes, CAVI showed the strongest correlation with all renal clinical outcomes. Central SBP was correlated with only urinary albumin-creatinine ratio, while renal resistive index was correlated with eGFRcreat and urinary albumin-creatinine ratio.
  
  
  CONCLUSIONS
  Decreased serum HDL cholesterol was independently and most closely associated with renal arteriolosclerosis. Of the vascular function indexes, CAVI had the greatest impact on renal clinical outcomes, although it was not associated with renal arteriolosclerosis.
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Tamehachi
authors: T
authors: Namikoshi
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Sohachi
authors: S
authors: Fujimoto
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Daisuke
authors: D
authors: Yorimitsu
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Chieko
authors: C
authors: Ihoriya
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Yasuo
authors: Y
authors: Fujimoto
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Norio
authors: N
authors: Komai
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Tamaki
authors: T
authors: Sasaki
authors: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
authors: Naoki
authors: N
authors: Kashihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D050379:Arteriolosclerosis / Q000175:diagnosis / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006439:Hemodynamics; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D033461:Hyperuricemia / Q000503:physiopathology; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000503:physiopathology*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D003404:Creatinine
keywords: arteriolosclerosis; blood pressure; kidney disease; vascular resistance; vascular stiffness