title: A prospective observational study comparing a non-operator dependent automatic PWV analyser to pulse pressure, in assessing arterial stiffness in hemodialysis.
abstract: BACKGROUND
  Chronic kidney disease (CKD) accelerates vascular stiffening related to age. Arterial stiffness may be evaluated measuring the carotid-femoral pulse wave velocity (PWV) or more simply, as recommended by KDOQI, monitoring pulse pressure (PP). Both correlate to survival and incidence of cardiovascular disease. PWV can also be estimated on the brachial artery using a Mobil-O-Graph; a non-operator dependent automatic device. The aim was to analyse whether, in a dialysis population, PWV obtained by Mobil-O-Graph (MogPWV) is more sensitive for vascular aging than PP.
  
  
  METHODS
  A cohort of 143 patients from 4 dialysis units has been followed measuring MogPWV and PP every 3 to 6 months and compared to a control group with the same risk factors but an eGFR > 30 ml/min.
  
  
  RESULTS
  MogPWV contrarily to PP did discriminate the dialysis population from the control group. The mean difference translated in age between the two populations was 8.4 years. The increase in MogPWV, as a function of age, was more rapid in the dialysis group. 13.3% of the dialysis patients but only 3.0% of the control group were outliers for MogPWV. The mortality rate (16 out of 143) was similar in outliers and inliers (7.4 and 8.0%/year). Stratifying patients according to MogPWV, a significant difference in survival was seen. A high parathormone (PTH) and to be dialysed for a hypertensive nephropathy were associated to a higher baseline MogPWV.
  
  
  CONCLUSIONS
  Assessing PWV on the brachial artery using a Mobil-O-Graph is a valid and simple alternative, which, in the dialysis population, is more sensitive for vascular aging than PP. As demonstrated in previous studies PWV correlates to mortality. Among specific CKD risk factors only PTH is associated with a higher baseline PWV.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02327962.
authors.affiliation: Division of Nephrology, Ospedale la Carità, Via Ospedale 1, 6600, Locarno, Switzerland. igor.salvade@chuv.ch.
authors.forename: Igor
authors.initials: I
authors.lastname: Salvadé
authors.affiliation: Division of Nephrology, Ospedale la Carità, Via Ospedale 1, 6600, Locarno, Switzerland. schaetti@gmx.net.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Schätti-Stählin
authors.affiliation: Division of Nephrology, Ospedale Civico, Lugano, Switzerland. eleonora.violetti@eoc.ch.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Violetti
authors.affiliation: Division of Nephrology, Ospedale Civico, Lugano, Switzerland. carlo.schoenholzer@eoc.ch.
authors.forename: Carlo
authors.initials: C
authors.lastname: Schönholzer
authors.affiliation: Division of Nephrology, Ospedale Beata Vergine, Mendrisio, Switzerland. claudio.cereghetti@eoc.ch.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cereghetti
authors.affiliation: Division of Nephrology, Ospedale San Giovanni, Bellinzona, Switzerland. hugo.zwahlen@eoc.ch.
authors.forename: Hugo
authors.initials: H
authors.lastname: Zwahlen
authors.affiliation: Division of Nephrology, Ospedale San Giovanni, Bellinzona, Switzerland. lorenzo.berwert@eoc.ch.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Berwert
authors.affiliation: Division of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland. michel.burnier@chuv.ch.
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.affiliation: Division of Nephrology, Ospedale la Carità, Via Ospedale 1, 6600, Locarno, Switzerland. luca.gabutti@eoc.ch.
authors.forename: Luca
authors.initials: L
authors.lastname: Gabutti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis / Q000295:instrumentation / Q000379:methods*; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D019722:Sphygmomanometers; D014463:Ultrasonography; D059289:Vascular Stiffness / Q000502:physiology*