Accelerated progression of arterial stiffness in dialysis patients compared with the general population

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression. METHODS: The study group included 80 patients undergoing hemodialysis (aged 59.3 +/- 11.8 years; duration of dialysis 5.47 +/- 5.16 years). The control group consisted of 60 patients (aged 57.5 +/- 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m2. Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures. RESULTS: The mean PWV values at baseline and 36 months were 11.18 +/- 2.29 and 11.82 +/- 2.34 m/sec in the CHP group, and 9.02 +/- 1.89 and 9.29 +/- 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 +/- 18.373 cm/sec in CHP and 27.28 +/- 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient beta [betast] = -0.405, p = 0.004; betast = -0.364, p = 0.011), albumin (betast = -0.349, p = 0.042; betast = -0.303, p = 0.034), CRP (betast = 0.458, p = 0.002; betast = 0.187, p = 0.008), and total cholesterol (betast = 0.236, p = 0.038; betast = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively. CONCLUSIONS: Accelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.