Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# North Zhongshan Road, Nanjing, 210003, China.
Department of Radiology, University of Washington, 850 Republican Street, Seattle, 98109, USA.
BMC Nephrol. 2019 Jul 30;20(1):288. doi: 10.1186/s12882-019-1484-x.
The reactive hyperemia index (RHI), measured by peripheral arterial tonometry (PAT), is a novel measurement of endothelial function and has been proven to be valuable in cardiovascular risk stratification in several populations. The current study aims to explore its relation to renal function and its association with traditional cardiovascular risk factors in patients with chronic kidney disease (CKD).
Subjects with non-dialysis dependent CKD were recruited and 252 of them had a successful PAT test. In addition to general demographic and medical information, carotid-femoral pulse wave velocity (cfPWV), carotid-radial pulse wave velocity (crPWV) and augmentation index (AIx) were recorded.
The mean age of the study population was 57.7 (±14.7) years and 155 (61.5%) were males. The average RHI was 1.92 (±14.7) with no difference noted between males and females. There was no statistically significant correlation between RHI and eGFR (r = - 0.107, p = 0.089) or urine protein-to-creatinine ratio (r = 0.036, p = 0.570). With adjustment for age and sex, RHI was associated with systolic blood pressure (BP) (β = 0.006, p = 0.001), diastolic BP (β = 0.008, p = 0.010), heart rate (β = - 0.007, p = 0.015) crPWV (β = 0.037, p = 0.022) and AIx (β = 0.006, p = 0.001), but not with cfPWV or any other conventional risk factors analyzed. Systolic BP remained the only predictor for RHI in the stepwise regression analysis.
RHI did not decline with reduced renal function in CKD patients and had a modest association with traditional cardiovascular risk factors. Further studies are warranted to determine if RHI could predict cardiovascular outcome in CKD patients.
外周动脉张力测定（PAT）测量的反应性充血指数（RHI）是一种新的内皮功能测量方法，已被证明在几种人群的心血管风险分层中有价值。本研究旨在探讨其与肾功能的关系，并研究其与慢性肾脏病（CKD）患者传统心血管危险因素的关系。
招募非透析依赖型 CKD 患者，其中 252 例成功进行了 PAT 测试。除了一般的人口统计学和医疗信息外，还记录了颈股脉搏波速度（cfPWV）、颈桡脉搏波速度（crPWV）和增强指数（AIx）。
研究人群的平均年龄为 57.7（±14.7）岁，155 例（61.5%）为男性。平均 RHI 为 1.92（±14.7），男性和女性之间无差异。RHI 与 eGFR（r = - 0.107，p = 0.089）或尿蛋白与肌酐比值（r = 0.036，p = 0.570）之间无统计学显著相关性。在校正年龄和性别后，RHI 与收缩压（BP）（β = 0.006，p = 0.001）、舒张压（BP）（β = 0.008，p = 0.010）、心率（β = - 0.007，p = 0.015）、crPWV（β = 0.037，p = 0.022）和 AIx（β = 0.006，p = 0.001）相关，但与 cfPWV 或任何其他分析的传统危险因素无关。在逐步回归分析中，收缩压仍然是 RHI 的唯一预测因子。
在 CKD 患者中，RHI 并未随肾功能下降而下降，与传统心血管危险因素有一定的相关性。需要进一步研究以确定 RHI 是否可以预测 CKD 患者的心血管结局。
