title: Modifiable risk factors for increased arterial stiffness in outpatient nephrology.
abstract: Arterial stiffness, as measured by pulse wave velocity (PWV), is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5%) patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV) was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV) - (upper limit of the age-adjusted PWV values for the general population). Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain; REDINREN, Madrid, Spain; Kasr El-Aini University Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Usama
authors.initials: U
authors.lastname: Elewa
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain; REDINREN, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Fernandez-Fernandez
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain; REDINREN, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Alegre
authors.affiliation: IDIPaz, Madrid, Spain.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Sanchez-Niño
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahillo-Fernández
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain; REDINREN, Madrid, Spain.
authors.forename: Maria Vanessa
authors.initials: MV
authors.lastname: Perez-Gomez
authors.affiliation: Kasr El-Aini University Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Hussein
authors.initials: H
authors.lastname: El-Fishawy
authors.affiliation: Kasr El-Aini University Hospitals, Cairo University, Cairo, Egypt.
authors.forename: Dawlat
authors.initials: D
authors.lastname: Belal
authors.affiliation: IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain; REDINREN, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D009398:Nephrology; D010045:Outpatients; D012307:Risk Factors; D059289:Vascular Stiffness