scholarly journals Aortic Calcification Affects Noninvasive Estimates of Central Blood Pressure in Patients with Severe Chronic Kidney Disease

2019 ◽  
Vol 44 (4) ◽  
pp. 704-714 ◽  
Author(s):  
Rasmus Kirkeskov Carlsen ◽  
Simon Winther ◽  
Christian D. Peters ◽  
Esben Laugesen ◽  
Dinah S. Khatir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Score ◽  
Mean Difference ◽  
Aortic Calcification ◽  
Ct Scans ◽  
Central Blood Pressure ◽  
Non Invasive ◽  
Ckd Stage

Background: Central blood pressure (BP) assessed noninvasively considerably underestimates true invasively measured aortic BP in chronic kidney disease (CKD) patients. The difference between the estimated and the true aortic BP increases with decreasing estimated glomerular filtration rates (eGFR). The present study investigated whether aortic calcification affects noninvasive estimates of central BP. Methods: Twenty-four patients with CKD stage 4–5 undergoing coronary angiography and an aortic computed tomography scan were included (63% males, age [mean ± SD ] 53 ± 11 years, and eGFR 9 ± 5 mL/min/1.73 m2). Invasive aortic BP was measured through the angiography catheter, while non-invasive central BP was obtained using radial artery tonometry with a SphygmoCor® device. The Agatston calcium score (CS) in the aorta was quantified on CT scans using the CS on CT scans. Results: The invasive aortic systolic BP (SBP) was 152 ± 23 mm Hg, while the estimated central SBP was 133 ± 20 mm Hg. Ten patients had a CS of 0 in the aorta, while 14 patients had a CS >0 in the aorta. The estimated central SBP was lower than the invasive aortic SBP in patients with aortic calcification compared to patients without (mean difference 8 mm Hg, 95% CI 0.3–16; p = 0.04). The brachial SBP was lower than the aortic SBP in patients with aortic calcification compared to patients without (mean difference 10 mm Hg, 95% CI 2–19; p = 0.02). Conclusion: In patients with advanced CKD the presence of aortic calcification is associated with a higher difference between invasively measured central aortic BP and non-invasive estimates of central BP as compared to patients without calcifications.

2.5 COMPARISON OF NON-INVASIVE AND INVASIVE MEASUREMENTS OF CENTRAL BLOOD PRESSURE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2014 ◽  
Vol 8 (4) ◽  
pp. 124
Author(s):  
R. Carlsen ◽  
C. Peters ◽  
D. Khatir ◽  
E. Laugesen ◽  
S. Winther ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Central Blood Pressure ◽  
Non Invasive

11.7 AORTIC CALCIUM SCORE AFFECTS NON-INVASIVELY OBTAINED ESTIMATES OF CENTRAL BLOOD PRESSURE IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE

2016 ◽  
Vol 16 (C) ◽  
pp. 76
Author(s):  
Rasmus K. Carlsen ◽  
Christian D. Peters ◽  
Esben Laugesen ◽  
Simon Winther ◽  
Dinah S. Khatir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Score ◽  
Central Blood Pressure ◽  
Advanced Chronic Kidney Disease

scholarly journals The Copenhagen chronic kidney disease echo study (COInCYDE)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Landler ◽  
S Bro ◽  
B Feldt-Rasmussen ◽  
D Hansen ◽  
A.L Kamper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Cardiac Function ◽  
Left Ventricular ◽  
Funding Source ◽  
Ckd Stage ◽  
Significant Difference ◽  
Stage 1

Abstract Background The cardiovascular mortality of patients with chronic kidney disease (CKD) is 2–10 times higher than in the average population. Purpose To estimate the prevalence of abnormal cardiac function or structure across the stages CKD 1 to 5nonD. Method Prospective cohort study. Patients with CKD stage 1 to 5 not on dialysis, aged 30 to 75 (n=875) and age-/sex-matched controls (n=173) were enrolled consecutively. All participants underwent a health questionnaire, ECG, morphometric and blood pressure measurements. Blood and urine were analyzed. Echocardiography was performed. Left ventricle (LV) hypertrophy, dilatation, diastolic and systolic dysfunction were defined according to current ESC guidelines. Results 63% of participants were men. Mean age was 58 years (SD 12.6 years). Mean eGFR was 46.7 mL/min/1,73 m (SD 25.8) for patients and 82.3 mL/min/1,73 m (SD 13.4) for controls. The prevalence of elevated blood pressure at physical exam was 89% in patients vs. 53% in controls. Patients were more often smokers and obese. Left ventricular mass index (LVMI) was slightly, albeit insignificantly elevated at CKD stages 1 & 2 vs. in kontrols: 3.1 g/m2, CI: −0.4 to 6.75, p-value 0.08. There was no significant difference in LV-dilatation between patients and controls. Decreasing diastolic and systolic function was observed at CKD stage 3a and later: LVEF decreased 0.95% (CI: −1.5 to −0.2), GLS increased 0.5 (CI: 0.3 to 0.8), and OR for diastolic dysfunction increased 3.2 (CI 1.4 to 7.3) pr. increment CKD stage group. Conclusion In accordance to previous studies, we observe in the CPHCKD cohort study signs of early increase of LVMI in patients with CKD stage 1 & 2. Significant decline in systolic and diastolic cardiac function is apparent already at stage 3 CKD. Figure 1. Estimated GFR vs. GLS & histogram of GLS Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): The Capital Region of Denmark

scholarly journals Serum Osteoprotegerin Is an Independent Marker of Metabolic Complications in Non-DialysisDependent Chronic Kidney Disease Patients

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3609
Author(s):  
Aleksandra Rymarz ◽  
Katarzyna Romejko ◽  
Anna Matyjek ◽  
Zbigniew Bartoszewicz ◽  
Stanisław Niemczyk
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycated Haemoglobin ◽  
Metabolic Disturbances ◽  
Protein Energy Wasting ◽  
Metabolic Complications ◽  
Logistic Regression Models ◽  
Ckd Stage ◽  
Independent Marker

Background: Osteoprotegerin (OPG) belongs to the tumour necrosis factor superfamily and is known to accelerate endothelial dysfunction and vascular calcification. OPG concentrations are elevated in patients with chronic kidney disease. The aim of this study was to investigate the association between OPG levels and frequent complications of chronic kidney disease (CKD) such as anaemia, protein energy wasting (PEW), inflammation, overhydration, hyperglycaemia and hypertension. Methods: One hundred non-dialysis-dependent men with CKD stage 3–5 were included in the study. Bioimpedance spectroscopy (BIS) was used to measure overhydration, fat amount and lean body mass. We also measured the serum concentrations of haemoglobin, albumin, total cholesterol, C-reactive protein (CRP), fibrinogen and glycated haemoglobin (HgbA1c), as well as blood pressure. Results: We observed a significant, positive correlation between OPG and age, serum creatinine, CRP, fibrinogen, HgbA1c concentrations, systolic blood pressure and overhydration. Negative correlations were observed between OPG and glomerular filtration rate (eGFR), serum albumin concentrations and serum haemoglobin level. Logistic regression models revealed that OPG is an independent marker of metabolic complications such as anaemia, PEW, inflammation and poor renal prognosis (including overhydration, uncontrolled diabetes and hypertension) in the studied population. Conclusion: Our results suggest that OPG can be an independent marker of PEW, inflammation and vascular metabolic disturbances in patients with chronic kidney disease.

[PS 08-42] ASSOCIATION OF CENTRAL BLOOD PRESSURE WITH MARKERS FOR TARGET ORGAN DAMAGE IN CHRONIC KIDNEY DISEASE PATIENTS

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e304
Author(s):  
Youn Kyung Kee ◽  
Chan-Yun Yoon ◽  
Seohyun Park ◽  
Jung Tak Park ◽  
Seung Hyeok Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Central Blood Pressure

scholarly journals Integrated central blood pressure–aortic stiffness risk score for cardiovascular risk stratification in chronic kidney disease

2018 ◽  
Vol 105 (4) ◽  
pp. 335-346 ◽  
Author(s):  
J Nemcsik ◽  
Á Tabák ◽  
D Batta ◽  
O Cseprekál ◽  
J Egresits ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Risk Score ◽  
Aortic Stiffness ◽  
Central Blood Pressure ◽  
Central Systolic Blood Pressure ◽  
Very High ◽  
Risk Categories

Background and aims The aim of this study was to develop an integrated central blood pressure–aortic stiffness (ICPS) risk score to predict cardiovascular events. Methods It was a retrospective cohort study. A total of 100 chronic kidney disease (CKD) patients on conservative therapy were included. Pulse wave velocity (PWV), central systolic blood pressure (cSBP), and central pulse pressure (cPP) were measured. A score was assigned to tertiles of PWV (0–2), cPP (0–2), and cSBP (0 to the first and second and 1 to the third tertile) based on each parameter’s ability to individually predict cardiovascular outcome. The sum of these scores and three ICPS risk categories as predictors were studied. Finally, we compared discrimination of the ICPS risk categories with PWV, cSBP, and cPP. Results Adjusted for age and sex, patients in high and very high ICPS risk categories had increased cardiovascular risk (HR: 3.52, 95% CI: 1.65–7.49; HR: 7.56, 95% CI: 3.20–17.85, respectively). High and very high ICPS risk categories remained independent predictors in a model adjusted for multiple CV risk factors (HR: 4.58, 95% CI: 1.65–7.49; HR: 8.56, 95% CI: 3.09–23.76, respectively). ICPS risk categories (Harrell’s C: 0.723, 95% CI: 0.652–0.795) showed better discrimination than PWV (Harrell’s C: 0.659, 95% CI: 0.586–0.732, p = 0.028) and cSBP (Harrell’s C: 0.660, 95% CI: 0.584–0.735, p = 0.008) and there has been a tendency of significance in case of cPP (Harrell’s C: 0.691, 95% CI: 0.621–0.761, p = 0.170). Conclusion The ICPS score may clinically importantly improve the identification of CKD patients with elevated cardiovascular risk.

scholarly journals Gut Microbiota-Dependent Trimethylamine N-Oxide Pathway Associated with Cardiovascular Risk in Children with Early-Stage Chronic Kidney Disease

2018 ◽  
Vol 19 (12) ◽  
pp. 3699 ◽  
Author(s):  
Chien-Ning Hsu ◽  
Pei-Chen Lu ◽  
Mao-Hung Lo ◽  
I-Chun Lin ◽  
Guo-Ping Chang-Chien ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Gut Microbiota ◽  
Early Stage ◽  
Microbial Composition ◽  
Ckd Stage ◽  
Subclinical Cvd

Despite cardiovascular disease (CVD) being the leading cause of morbidity and mortality in chronic kidney disease (CKD), less attention has been paid to subclinical CVD in children and adolescents with early CKD stages. Gut microbiota and their metabolite, trimethylamine N-oxide (TMAO), have been linked to CVD. Ambulatory blood-pressure monitoring (ABPM) and arterial-stiffness assessment allow for early detection of subclinical CVD. We therefore investigated whether gut microbial composition and TMAO metabolic pathway are correlated with blood-pressure (BP) load and vascular abnormalities in children with early-stage CKD. We enrolled 86 children with G1–G3 CKD stages. Approximately two-thirds of CKD children had BP abnormalities on ABPM. Children with CKD stage G2–G3 had a higher uric acid level (6.6 vs. 4.8 mg/dL, p < 0.05) and pulse-wave velocity (4.1 vs. 3.8 m/s, p < 0.05), but lower TMAO urinary level (209 vs. 344 ng/mg creatinine, p < 0.05) than those with stage G1. Urinary TMAO level was correlated with the abundances of genera Bifidobacterium (r = 0.307, p = 0.004) and Lactobacillus (r = 0.428, p < 0.001). CKD children with abnormal ABPM profile had a lower abundance of the Prevotella genus than those with normal ABPM (p < 0.05). Our results highlight the link between gut microbiota, microbial metabolite TMAO, BP load, and arterial-stiffness indices in children with early-stage CKD. Early assessments of these surrogate markers should aid in decreasing cardiovascular risk in childhood CKD.

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