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The importance of accurate measurement of aortic stiffness in patients with chronic kidney disease and end-stage renal disease.pdf (913.76 kB)

The importance of accurate measurement of aortic stiffness in patients with chronic kidney disease and end-stage renal disease

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posted on 2018-03-12, 10:48 authored by Sherna F. Adenwalla, Matthew P.M. Graham-Brown, Francesca M.T. Leone, James O. Burton, Gerry P. McCann
Cardiovascular (CV) disease is the leading cause of death in chronic kidney disease (CKD) and end-stage renal disease (ESRD). A key driver in this pathology is increased aortic stiffness, which is a strong, independent predictor of CV mortality in this population. Aortic stiffening is a potentially modifiable biomarker of CV dysfunction and in risk stratification for patients with CKD and ESRD. Previous work has suggested that therapeutic modification of aortic stiffness may ameliorate CV mortality. Nevertheless, future clinical implementation relies on the ability to accurately and reliably quantify stiffness in renal disease. Pulse wave velocity (PWV) is an indirect measure of stiffness and is the accepted standard for non-invasive assessment of aortic stiffness. It has typically been measured using techniques such as applanation tonometry, which is easy to use but hindered by issues such as the inability to visualize the aorta. Advances in cardiac magnetic resonance imaging now allow direct measurement of stiffness, using aortic distensibility, in addition to PWV. These techniques allow measurement of aortic stiffness locally and are obtainable as part of a comprehensive, multiparametric CV assessment. The evidence cannot yet provide a definitive answer regarding which technique or parameter can be considered superior. This review discusses the advantages and limitations of non-invasive methods that have been used to assess aortic stiffness, the key studies that have assessed aortic stiffness in patients with renal disease and why these tools should be standardized for use in clinical trial work.

History

Citation

Clinical Kidney Journal, 2017, 10 (4), pp. 503-515

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Infection, Immunity and Inflammation

Version

  • VoR (Version of Record)

Published in

Clinical Kidney Journal

Publisher

Oxford University Press for European Renal Association

issn

2048-8505

eissn

2048-8513

Acceptance date

2017-03-21

Copyright date

2017

Available date

2018-03-12

Publisher version

https://academic.oup.com/ckj/article/10/4/503/3813275

Language

en

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