The significance of micro- and macrovascular biomarkers on cardiovascular outcome in chronic kidney disease: a prospective cohort study

• Published in: Journal of human hypertension 2016-07, Vol.30 (7), p.449-455
• Main Authors: Cseprekál, O, Egresits, J, Tabák, Á, Nemcsik, J, Járai, Z, Babos, L, Fodor, E, Farkas, K, Godina, G, Kárpáthi, K I, Kerkovits, L, Marton, A, Nemcsik-Bencze, Z, Németh, Z, Sallai, L, Kiss, I, Tislér, A
• Format: Article
• Language: English
• Subjects: 692/499; 692/700/1750; Aged; Analysis; Arteries; Blood Pressure; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; Care and treatment; Chronic kidney failure; Cohort analysis; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Doppler effect; Epidemiology; Female; Fibroblast growth factors; Glomerular Filtration Rate; Health Administration; Humans; Hyperemia; Hyperemia - physiopathology; Hypertension; Information processing; Kidney - physiopathology; Kidney diseases; Lasers; Male; Medicine; Medicine & Public Health; Microcirculation; Microvasculature; Middle Aged; Mortality; Multivariate Analysis; original-article; Prognosis; Proportional Hazards Models; Prospective Studies; Public Health; Pulsatile Flow; Pulse Wave Analysis; Regression analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - physiopathology; Risk Factors; Severity of Illness Index; Time Factors; Vascular Stiffness
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2015.96

Measures of small and large artery dysfunction have not been investigated in a single cohort for the prediction of cardiovascular (CV) events in patients with nondialysed (ND) chronic kidney disease (CKD). This prospective cohort study aimed to determine whether central pulse wave velocity (cPWV), central pulse pressure (CPP) or microvascular post-occlusive reactive hyperaemia area (PORH HA ) independently predict CV events and mortality in CKD-ND. A total of 94 stage 1–5 CKD-ND (65.3±13.1 years; estimated glomerular filtration rate 35.3 (22.8–49.4) ml min −1 per 1.73 m 2 ) patients were followed-up for a median of 52 (36–65) months and had baseline cPWV and CPP measured by applanation tonometry and PORH HA by laser Doppler flowmetry. Multiple failure time Cox regression models were used to determine the predictive role of vascular parameters on CV mortality and events. Based on multiple linear regressions, baseline age, diabetes, CV disease, and systolic blood pressure (SBP) were independently related to cPWV ( R 2 =0.3), SBP and PORH HA to CPP ( R 2 =0.45), whereas CPP was the only parameter independently related to PORH HA ( R 2 =0.16, all P