Endothelium-Dependent and -Independent Vascular Function in Advanced Chronic Kidney Disease

Autor: John S. Sampalis, Naomi M. Hamburg, Joseph A. Vita, James S. Kaufman, Laura M. Dember, Tal Kopel
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Brachial Artery
Epidemiology
Vasodilator Agents
030232 urology & nephrology
Renal function
030204 cardiovascular system & hematology
Kidney
Critical Care and Intensive Care Medicine
Severity of Illness Index
End stage renal disease
Coronary artery disease
Nitroglycerin
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine.artery
Odds Ratio
medicine
Humans
Renal Insufficiency
Chronic
Brachial artery
Aged
Transplantation
Chi-Square Distribution
Vascular disease
business.industry
Original Articles
Odds ratio
Middle Aged
medicine.disease
Vasodilation
Cross-Sectional Studies
Logistic Models
Cardiovascular Diseases
Regional Blood Flow
Nephrology
Multivariate Analysis
Linear Models
Cardiology
Female
Endothelium
Vascular
business
Chi-squared distribution
Kidney disease
Zdroj: Clinical Journal of the American Society of Nephrology. 12:1588-1594
ISSN: 1555-905X
1555-9041
DOI: 10.2215/cjn.12811216
Popis: Background and objectives CKD is associated with increased cardiovascular risk not fully attributable to traditional risk factors. We compared endothelium-dependent and -independent vascular function among individuals with advanced CKD with function in those with vascular disease but preserved kidney function. Design, setting, participants, & measurements Matched cohort analysis randomly selected from 1259 participants at a single center with measurements of brachial artery flow–mediated dilation, an endothelium-dependent process, and nitroglycerin-mediated dilation, an endothelium-independent process. Patients with advanced CKD (n=70) were matched 1:1 to controls with preserved kidney function and (1) no overt vascular disease, (2) hypertension, and (3) coronary artery disease. Results The trend toward lower flow-mediated dilation (mean±SEM) in advanced CKD (5.4%±0.5%) compared with no overt vascular disease (7.3%±0.6%), hypertension (6.2%±0.5%), and coronary artery disease (5.8%±0.5%) did not reach statistical significance in adjusted analyses (P=0.05). Nitroglycerin-mediated dilation was lower in advanced CKD compared with in the other groups (adjusted nitroglycerin-mediated dilation: 6.9%±0.8%, 11.8%±0.9%, 11.0%±0.7%, and 10.5%±0.7% in advanced CKD, no overt vascular disease, hypertension, and coronary artery disease groups, respectively; P Conclusions Impairment in endothelium-dependent vascular function is present in patients with CKD and those with clinically evident vascular disease but preserved kidney function. In contrast, substantial reduction in endothelium-independent function was observed only in the CKD group, suggesting differences in severity and pathophysiology of vascular dysfunction between CKD and other disease states.
Databáze: OpenAIRE
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