Association Between Arterial Stiffness and Measures of Autonomic Dysfunction in People With Chronic Kidney Disease.

IF 1.6 Q3 UROLOGY & NEPHROLOGY Canadian Journal of Kidney Health and Disease Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI:10.1177/20543581231213798
Rachelle Davies, Natasha Wiebe, Andrew Brotto, Michael K Stickland, Branko Braam, Stephanie Thompson
{"title":"Association Between Arterial Stiffness and Measures of Autonomic Dysfunction in People With Chronic Kidney Disease.","authors":"Rachelle Davies, Natasha Wiebe, Andrew Brotto, Michael K Stickland, Branko Braam, Stephanie Thompson","doi":"10.1177/20543581231213798","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autonomic nervous system (ANS) dysfunction and vascular stiffness increase cardiovascular risk in people with chronic kidney disease (CKD). Chronic elevations in sympathetic activity can lead to increased arterial stiffness; however, the relationship between these variables is unknown in CKD.</p><p><strong>Objective: </strong>To explore the association between measures of autonomic function and arterial stiffness in patients with moderate-to-severe CKD.</p><p><strong>Methods: </strong>This study was a prespecified secondary analysis of a randomized controlled trial. This included the following measures: 24-hour ambulatory blood pressure (BP), carotid-femoral and carotid-radial pulse wave velocity (PWV), and postexercise heart rate recovery (HRR). We used mixed effect linear regression models with Bayesian information criteria (BIC) to assess the contribution of ANS measurements.</p><p><strong>Results: </strong>Forty-four patients were included in the analysis. Mean carotid-femoral and carotid-radial PWV were 7.12 m/s (95% CI 6.13, 8.12) and 8.51 m/s (7.90, 9.11), respectively. Mean systolic dipping, calculated as percentage change in mean systolic readings from day to night, was 10.0% (95% CI 7.79, 12.18). Systolic dipping was independently associated with carotid-radial PWV, MD -0.09 m/s (95% CI -0.15, -0.02) and had the lowest BIC.</p><p><strong>Conclusions: </strong>Systolic dipping was associated with carotid-radial PWV in people with moderate-to-severe CKD; however, there was no association with carotid-femoral PWV. Systolic dipping may be a feasible surrogate of ANS function, as the association with carotid-radial PWV was consistent with the minimal clinically important difference (MCID). Future studies are needed to define the relationship between ANS function, arterial stiffness, and CV events over time in people with CKD.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"10 ","pages":"20543581231213798"},"PeriodicalIF":1.6000,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664430/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Kidney Health and Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20543581231213798","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Autonomic nervous system (ANS) dysfunction and vascular stiffness increase cardiovascular risk in people with chronic kidney disease (CKD). Chronic elevations in sympathetic activity can lead to increased arterial stiffness; however, the relationship between these variables is unknown in CKD.

Objective: To explore the association between measures of autonomic function and arterial stiffness in patients with moderate-to-severe CKD.

Methods: This study was a prespecified secondary analysis of a randomized controlled trial. This included the following measures: 24-hour ambulatory blood pressure (BP), carotid-femoral and carotid-radial pulse wave velocity (PWV), and postexercise heart rate recovery (HRR). We used mixed effect linear regression models with Bayesian information criteria (BIC) to assess the contribution of ANS measurements.

Results: Forty-four patients were included in the analysis. Mean carotid-femoral and carotid-radial PWV were 7.12 m/s (95% CI 6.13, 8.12) and 8.51 m/s (7.90, 9.11), respectively. Mean systolic dipping, calculated as percentage change in mean systolic readings from day to night, was 10.0% (95% CI 7.79, 12.18). Systolic dipping was independently associated with carotid-radial PWV, MD -0.09 m/s (95% CI -0.15, -0.02) and had the lowest BIC.

Conclusions: Systolic dipping was associated with carotid-radial PWV in people with moderate-to-severe CKD; however, there was no association with carotid-femoral PWV. Systolic dipping may be a feasible surrogate of ANS function, as the association with carotid-radial PWV was consistent with the minimal clinically important difference (MCID). Future studies are needed to define the relationship between ANS function, arterial stiffness, and CV events over time in people with CKD.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
慢性肾病患者动脉僵硬度与自主神经功能障碍之间的关系
背景:自主神经系统(ANS)功能障碍和血管僵硬增加慢性肾脏疾病(CKD)患者的心血管风险。交感神经活动的慢性升高可导致动脉僵硬度增加;然而,CKD中这些变量之间的关系尚不清楚。目的:探讨中重度CKD患者自主神经功能与动脉僵硬度的关系。方法:本研究是一项预先指定的随机对照试验的二次分析。这包括以下测量:24小时动态血压(BP),颈动脉-股动脉和颈动脉-桡动脉脉搏波速度(PWV),以及运动后心率恢复(HRR)。我们使用带有贝叶斯信息准则(BIC)的混合效应线性回归模型来评估ANS测量的贡献。结果:44例患者纳入分析。颈动脉-股动脉和颈动脉-桡动脉的平均PWV分别为7.12 m/s (95% CI 6.13, 8.12)和8.51 m/s(7.90, 9.11)。平均收缩压下降,以昼夜平均收缩压读数变化百分比计算,为10.0% (95% CI 7.79, 12.18)。收缩期倾斜与颈动脉-桡动脉PWV独立相关,MD -0.09 m/s (95% CI -0.15, -0.02), BIC最低。结论:收缩期倾斜与中重度CKD患者颈动脉-桡动脉PWV相关;然而,与颈-股动脉PWV无关。收缩期倾斜可能是ANS功能的可行替代指标,因为与颈动脉-桡动脉PWV的相关性与最小临床重要差异(MCID)一致。未来的研究需要明确慢性肾病患者ANS功能、动脉僵硬度和CV事件之间的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
3.00
自引率
5.90%
发文量
84
审稿时长
12 weeks
期刊介绍: Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
期刊最新文献
Is Childhood IgA Nephropathy Different From Adult IgA Nephropathy? A Narrative Review. Impact of Baseline Kidney Function on the Rate of Progressive Kidney Disease After Pregnancy: A Population-Based Cohort Study Research Protocol. Clinical and Pathological Characteristics of Non-AL Amyloidosis MGRS: A Single-Center Experience Over 10 Years. Shared Decision-Making Aid for Stroke-Prevention Strategies in Patients With Atrial Fibrillation Receiving Maintenance Hemodialysis (SIMPLIFY-HD): A Mixed-Methods Study. Cultivating Innovative, Pragmatic, Randomized Controlled Registry Trials Embedded in Hemodialysis Care: Conference Proceeding From Gardener's Grove 2023.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1