Bahous Sola Aoun, Stephan Antoine, Blacher Jacques, Safar Michel E
Nephrology and Transplantation Center, Rizk Hopsital, Beirut, Lebanon.
Hypertension. 2006 Feb;47(2):216-21. doi: 10.1161/01.HYP.0000201234.35551.2e. Epub 2006 Jan 9.
In subjects with renal disease, reduced renal function and increased arterial stiffness are significantly associated in cross-sectional studies. The relationship is independent of age, blood pressure (BP), and atherosclerosis. Because both variables are independent predictors of cardiovascular risk, time-dependent relationships between them are important to determine. Aortic pulse wave velocity was measured noninvasively by comparison with healthy volunteers in 101 living kidney donors and their 101 corresponding recipients. Healthy volunteers were divided into 2 groups: one was recipient related through familial links and the other was nonrecipient related. Independently of age, gender, and BP, pulse wave velocity was significantly elevated in donors and recipients by comparison with the 2 groups of healthy volunteers. Pulse wave velocity was significantly higher in the recipient-related than in the nonrecipient-related group. Whereas in healthy volunteers, pulse wave velocity was exclusively related to age, gender, and BP, in donors and recipients, it was rather associated with a cluster of cardiovascular risk factors, including smoking habits and plasma glucose. Major factors related to pulse wave velocity were renal: time since nephrectomy (donation date) in donors, in whom pulse pressure was specifically associated with proteinuria, and renal rejection in recipients. Plasma creatinine doubling secondary to chronic allograft nephropathy was significantly associated with renal rejection and donor pulse wave velocity, independent of age. Our findings strongly suggest consistent interactions (including familial factors) between kidney function and arterial stiffness. Assessment of cause-effect relationships and implication of biochemical and/or genetic factors warrant additional studies.
在横断面研究中，肾病患者的肾功能降低与动脉僵硬度增加显著相关。这种关系独立于年龄、血压（BP）和动脉粥样硬化。由于这两个变量都是心血管风险的独立预测因素，因此确定它们之间的时间依赖性关系很重要。通过与健康志愿者比较，对101名活体肾供体及其101名相应受体进行了无创主动脉脉搏波速度测量。健康志愿者分为两组：一组是通过家族联系与受体相关的，另一组是与受体无关的。独立于年龄、性别和血压，与两组健康志愿者相比，供体和受体的脉搏波速度显著升高。与受体无关的组相比，与受体相关的组的脉搏波速度显著更高。在健康志愿者中，脉搏波速度仅与年龄、性别和血压有关，而在供体和受体中，它与一系列心血管危险因素相关，包括吸烟习惯和血糖。与脉搏波速度相关的主要因素是肾脏因素：供体中自肾切除（捐赠日期）以来的时间，其中脉压与蛋白尿特别相关，以及受体中的肾排斥反应。继发于慢性移植肾肾病的血浆肌酐翻倍与肾排斥反应和供体脉搏波速度显著相关，与年龄无关。我们的研究结果强烈表明肾功能与动脉僵硬度之间存在一致的相互作用（包括家族因素）。对因果关系以及生化和/或遗传因素的影响进行评估需要进一步研究。
