BACKGROUND: Factors associated with chronic kidney disease (CKD) contribute to an increased risk of cardiovascular disease and death. The impact of vascular disease on CKD progression is, however, less well studied. METHODS: We examined the effect of markers of vascular disease on the risk of progression to end-stage renal disease (ESRD) in 35 patients with CKD stages 4-5. Superficial femoral artery calcification was assessed by CT scan. Augmentation index (AI) and pulse wave velocity (PWV) were measured by applanation tonometry. RESULTS: After 12.4 (5.5-28.4) months, 22/35 patients (63%) had commenced dialysis. Cox regression analysis identified baseline estimated glomerular filtration rate (hazard ratio, HR, 0.54; 95% CI 0.41-0.70; p < 0.0001), urinary protein (HR 1.84; 95% CI 1.32-2.58; p = 0.0005), PWV (HR 1.30; 95% CI 1.07-1.60; p = 0.01), AI (HR 1.08; 95% CI 1.04-1.14; p = 0.0001) and pack years of smoking (HR 1.01; 95% CI 1.00-1.03; p = 0.02) as independent risk factors for time to ESRD (-2 log likelihood = 86.7; chi(2) = 30.9; p < 0.0001). Repeat analysis using AI as a categorical variable revealed an HR of 17.5 (95% CI 4.43-68.9; p < 0.0001) for time to ESRD in those with AI above versus below the median. CONCLUSIONS: We have identified two markers of arterial stiffness as independent risk factors for progression to ESRD suggesting that vascular disease may contribute to CKD progression. (c) 2007 S. Karger AG, Basel
BACKGROUND: Factors associated with chronic kidney disease (CKD) contribute to an increased risk of cardiovascular disease and death. The impact of vascular disease on CKD progression is, however, less well studied. METHODS: We examined the effect of markers of vascular disease on the risk of progression to end-stage renal disease (ESRD) in 35 patients with CKD stages 4-5. Superficial femoral artery calcification was assessed by CT scan. Augmentation index (AI) and pulse wave velocity (PWV) were measured by applanation tonometry. RESULTS: After 12.4 (5.5-28.4) months, 22/35 patients (63%) had commenced dialysis. Cox regression analysis identified baseline estimated glomerular filtration rate (hazard ratio, HR, 0.54; 95% CI 0.41-0.70; p < 0.0001), urinary protein (HR 1.84; 95% CI 1.32-2.58; p = 0.0005), PWV (HR 1.30; 95% CI 1.07-1.60; p = 0.01), AI (HR 1.08; 95% CI 1.04-1.14; p = 0.0001) and pack years of smoking (HR 1.01; 95% CI 1.00-1.03; p = 0.02) as independent risk factors for time to ESRD (-2 log likelihood = 86.7; chi(2) = 30.9; p < 0.0001). Repeat analysis using AI as a categorical variable revealed an HR of 17.5 (95% CI 4.43-68.9; p < 0.0001) for time to ESRD in those with AI above versus below the median. CONCLUSIONS: We have identified two markers of arterial stiffness as independent risk factors for progression to ESRD suggesting that vascular disease may contribute to CKD progression. (c) 2007 S. Karger AG, Basel
Authors: O Cseprekál; J Egresits; Á Tabák; J Nemcsik; Z Járai; L Babos; E Fodor; K Farkas; G Godina; K I Kárpáthi; L Kerkovits; A Marton; Z Nemcsik-Bencze; Z Németh; L Sallai; I Kiss; A Tislér Journal: J Hum Hypertens Date: 2015-10-01 Impact factor: 3.012
Authors: Carmen A Peralta; David R Jacobs; Ronit Katz; Joachim H Ix; Magdalena Madero; Daniel A Duprez; Mark J Sarnak; Michael H Criqui; Holly J Kramer; Walter Palmas; David Herrington; Michael G Shlipak Journal: Am J Kidney Dis Date: 2011-10-14 Impact factor: 8.860
Authors: Katherine H Michener; Gary F Mitchell; Farzad Noubary; Naya Huang; Tamara Harris; Margret B Andresdottir; Runolfur Palsson; Vilmundur Gudnason; Andrew S Levey Journal: Am J Nephrol Date: 2015-06-06 Impact factor: 3.754
Authors: Magdalena Madero; Carmen Peralta; Ronit Katz; Robert Canada; Linda Fried; Samer Najjar; Michael Shlipak; Eleanor Simonsick; Edward Lakatta; Kushang Patel; Dena Rifkin; Marquis Hawkins; Anne Newman; Mark Sarnak Journal: Clin J Am Soc Nephrol Date: 2012-12-27 Impact factor: 8.237