Sági B, Késői I, Késői B, Vas T, Csiky B, Kovács T, Nagy J
1 2nd Department of Internal Medicine and Nephrological Centre, Clinical Centre, Medical School, University of Pécs , Pécs, Hungary.
2 Internal Medicine Department, Mining Rehabilitation and Night Time Sanatorium, Health Centre of Komló , Komló, Hungary.
Physiol Int. 2018 Jun 1;105(2):145-156. doi: 10.1556/2060.105.2018.2.17.
Background and aims Autosomal-dominant polycystic kidney disease (ADPKD) is one of the most common causes of end-stage renal disease (ESRD). The most important cause of death among ADPKD patients is cardiovascular (CV). The aim of this study was to examine the prognostic significance of arterial stiffness on CV and renal outcomes in ADPKD. Methods A total of 55 patients with ADPKD were examined. Pulse wave velocity was determined and stiffness index (SI) was calculated. Combined primary endpoints (CV and renal) were major CV events (myocardial infarction, stroke, and CV intervention) as CV endpoints, and attaining of ESRD or start of renal replacement therapy as renal endpoints. Secondary endpoints were CV or renal endpoints separately. Results The mean age of those 55 ADPKD patients was 45 ± 12 years, 21 patients were male. The average value of the SI was 11.11 ± 2.22 m/s. The patients were divided into two groups by the cutoff value of 11 m/s of SI and then outcomes were analyzed. In the higher arterial stiffness group (SI > 11 m/s), occurrence of combined primary endpoint (CV and renal) was significantly higher than in the group with more elastic arteries (p = 0.033). A statistically significant difference was found in the renal endpoints (p = 0.018), but not in the CV endpoints (p = 0.952) between the two groups. Conclusions Increased arterial stiffness predicts the onset of ESRD in ADPDK. Assessment of SI appears to be a useful method for estimating the renal and CV prognosis in ADPKD.
背景与目的 常染色体显性遗传性多囊肾病（ADPKD）是终末期肾病（ESRD）最常见的病因之一。ADPKD患者最重要的死亡原因是心血管（CV）疾病。本研究旨在探讨动脉僵硬度对ADPKD患者心血管和肾脏结局的预后意义。方法 共检查了55例ADPKD患者。测定脉搏波速度并计算僵硬度指数（SI）。联合主要终点（心血管和肾脏）作为心血管终点是主要心血管事件（心肌梗死、中风和心血管干预），作为肾脏终点是达到ESRD或开始肾脏替代治疗。次要终点分别是心血管或肾脏终点。结果 55例ADPKD患者的平均年龄为45±12岁，男性21例。SI的平均值为11.11±2.22m/s。根据SI的临界值11m/s将患者分为两组，然后分析结局。在动脉僵硬度较高的组（SI>11m/s）中，联合主要终点（心血管和肾脏）的发生率显著高于动脉弹性较好的组（p=0.033）。两组之间在肾脏终点方面存在统计学显著差异（p=0.018），但在心血管终点方面无差异（p=0.952）。结论 动脉僵硬度增加可预测ADPKD患者ESRD的发生。评估SI似乎是评估ADPKD患者肾脏和心血管预后的一种有用方法。
