Clinic of Gastroenterology, Nephrourology and Abdominal Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Aging Clin Exp Res. 2019 Feb;31(2):193-199. doi: 10.1007/s40520-018-0971-4. Epub 2018 May 19.
The change of aortic stiffness, but not the particular baseline value, plays a crucial role in estimating the patient risk with end-stage renal disease. Therefore, we aimed to analyze the evolution of central and peripheral arterial stiffness in hemodialysis population without previous cardiovascular events during a 2-year follow-up.
60 hemodialysis patients (mean age 57.61 ± 13.01 years) were prospectively interviewed, and they underwent blood tests, chest X-ray for aortic calcification evaluation and pulse wave velocity (PWV) measurements at the baseline, after 6 months and after 2 years of observation period.
We found significant progression of aortic PWV (12.73 vs. 14.24 m/s, p = 0.032) and regression of brachial PWV (11.53 vs. 8.85 m/s, p < 0.001). CRP increase influenced evolution of aortic PWV (β = 0.331, p = 0.031, R = 0.599). Higher β2-microglobulin values was related to the progression of aortic PWV (β = 0.219, p = 0.022, R = 0.568). Mean arterial blood pressure had influence only on the short-term arterial stiffness evolution.
Patients on maintenance hemodialysis experience pronounced changes of arterial stiffness during the 2-year follow-up period. The progression of aortic stiffness is related to inflammatory response and particularly is influenced by β2-microglobulin concentration and aortic calcification.
主动脉僵硬度的变化，而不是特定的基线值，在估计终末期肾病患者的患者风险方面起着至关重要的作用。因此，我们旨在分析在 2 年随访期间没有先前心血管事件的血液透析人群中心脏和外周动脉僵硬度的演变。
前瞻性访谈了 60 名血液透析患者（平均年龄 57.61 ± 13.01 岁），他们在基线、6 个月和 2 年观察期后进行了血液检查、胸部 X 射线评估主动脉钙化和脉搏波速度（PWV）测量。
我们发现主动脉 PWV 显著进展（12.73 与 14.24 m/s，p = 0.032），肱动脉 PWV 显著降低（11.53 与 8.85 m/s，p < 0.001）。CRP 升高影响主动脉 PWV 的演变（β = 0.331，p = 0.031，R = 0.599）。β2-微球蛋白值较高与主动脉 PWV 的进展相关（β = 0.219，p = 0.022，R = 0.568）。平均动脉压仅对短期动脉僵硬度演变有影响。
维持性血液透析患者在 2 年随访期间经历了动脉僵硬度的明显变化。主动脉僵硬度的进展与炎症反应有关，特别是与β2-微球蛋白浓度和主动脉钙化有关。
