Highlights
- •CKD and UC are characterized by different arterial phenotypes.
- •In patients with UC, the stiffness of both elastic and muscular arteries is increased.
- •In patients with CKD, the stiffness mismatch starts early, from stage 3B CKD.
Abstract
Background
We hypothesized that a reversal of the physiological stiffness gradient, previously
reported in end-stage renal disease, begins in the early stages of chronic kidney
disease (CKD) and that chronic inflammation produces a different arterial phenotype
in patients with ulcerative colitis (UC).
Objectives
To assess the extent of arterial stiffening in the central (carotid-femoral pulse
wave velocity, cf.-PWV) and peripheral arteries (carotid-radial pulse wave velocity,
cr-PWV) and to explore the determinants of the stiffness gradient in UC and in CKD.
Methods
We enrolled 45 patients with UC, 45 patients with stage 3–4 CKD and 45 matched controls.
Results
Despite the comparable cf.-PWV, the cr-PWV was higher in patients with UC than in
those with CKD (median: 8.7 vs. 7.5 m/s; p < 0.001) and, consequently, the PWV ratio was lower (median: 0.97 vs. 1.12; p < 0.001). In patients with CKD a stiffness mismatch was reported starting from stage
3B. The PWV ratio was associated with age and C-reactive protein (beta: 0.08 z-score,
95%CI 0.02–0.14; p = 0.01) or active disease (beta: 0.43 z-score, 95%CI 0.003–0.857; p = 0.048) in patients with UC and with age and glomerular filtration rate (beta: −0.56 z-score, 95%CI −1.05 to −0.07; p = 0.02) in patients with CKD.
Conclusions
The arterial phenotype differed between UC and CKD. The reversal of the arterial stiffness
gradient is evident in CKD patients starting from stage 3B but not in patients with
UC and comparable cf.-PWV. In patients with UC, the stiffness of both elastic and
muscular arteries is increased as a consequence of inflammation.
Graphical abstract
Graphical Abstract
Abbreviations:
[email protected] (heart-rate-adjusted central augmentation index), Anti-TNF (anti-tumor necrosis factor), cf-PWV (carotid-femoral pulse wave velocity), CKD (chronic kidney disease), cr-PWV (carotid-radial pulse wave velocity), DBP (diastolic blood pressure), eGFR (estimated GFR), IBD (inflammatory bowel disease), MBP (mean blood pressure), PP (pulse pressure), SBP (systolic blood pressure), UC (ulcerative colitis)Keywords
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Article info
Publication history
Published online: August 19, 2017
Accepted:
August 17,
2017
Received in revised form:
August 3,
2017
Received:
May 21,
2017
Footnotes
☆All authors have contributed equally.
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
