Aortic stiffness and its influencing factors in patients with chronic kidney disease
10.3785/j.issn.1008-9292.2016.09.09
- VernacularTitle:慢性肾脏病患者主动脉僵硬度相关指数变化及影响因素分析
- Author:
Binxian YE
1
;
Li ZHAO
;
Wei SHEN
;
Yan REN
;
Bo LIN
;
Maosheng CHEN
;
Junda TANG
;
Xinxin JIANG
;
Yiwen LI
;
Qiang HE
Author Information
1. 浙江省人民医院肾脏病科
- Keywords:
Kidney diseases/physiopathology;
Arteriosclerosis;
Blood pressure
- From:
Journal of Zhejiang University. Medical sciences
2016;45(5):507-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the changes of aortic stiffness and its influencing factors in patients with chronic kidney diseases ( CKD) .Methods:Eighty-four patients with CKD from Department of Nephrology , Zhejiang Provincial People ’ s Hospital were divided into the dialysis group ( CKD stage 5 , n=48 ) and non-dialysis group ( CKD stage 3 -5 , n =36 ) . Clinical data , biochemical parameters and echocardiography findings were collected .SphygmoCor pulse wave analysis system was used to obtain pulse wave analysis ( PWA ) parameters including central aortic systolic blood pressure ( CSP ) , central pulse pressure ( CPP ) , augmented pressure ( AP ) , augmentation index ( AIX ) , and heart rate 75 -adjusted augmentation index ( HR75 AIX ) .The influencing factors of aortic stiffness were analyzed by spearman correlation analysis and multiple regression analysis .Results: CSP, CPP, AP, AIX and HR75 AIX in dialysis patients had no significant differences compared with those in non-dialysis group (all P>0.05).Spearman correlation analysis showed that CSP was positively correlated with systolic blood pressure , diastolic blood pressure , cholesterol , low-density lipoprotein cholesterol , left atrial diameter ( LA ) , left ventricular systolic diameter ( LVDs ) , left ventricular diastolic diameter ( LVDd ) , and negatively correlated with calcium and hemoglobin levels . CPP was positively correlated with systolic blood pressure , age, LA, LVDd, and negatively correlated with diastolic blood pressure and hemoglobin levels . AP was positively correlated with systolic blood pressure, age, LA, LVDd, and negatively correlated with hemoglobin levels .AIX was positively correlated with systolic blood pressure , age, sodium, and negatively correlated with phosphorus levels .HR75AIX was positively correlated with systolic blood pressure , sodium , cholesterol , and negatively correlated with hemoglobin and albumin levels .Multiple regression analysis showed that higher systolic blood pressure was the independent risk factor for CSP (β=0.944, P<0.01);lower diastolic blood pressure (β=0.939, P<0.01) and higher systolic blood pressure (β=-1.010, P<0.01) were the independent risk factors for CPP; older age (β=0.237, P <0.01) and higher systolic blood pressure (β=0.200,P<0.01) were the independent risk factors for AP; higher systolic blood pressure (β=0 .163 and 0 .115 , P<0 .05 and P<0.01 ) and higher sodium (β=0.646 and 0.625, all P <0.05 ) were independent risk factors for both AIX and HR 75 AIX.Conclusions: No significant correlation is observed between aortic stiffness and CKD of different stages .Control blood pressure and restrict sodium intake may be effective means of delaying arterial stiffness in patients with CKD .