Determinants of arterial distensibility in patients with renal failure

Background: An increased stiffness of the arterial system is an adverse risk factor for the outcome in patients with renal disease. Few studies have focused on the determinants of an increased arterial stiffness in patients with renal failure. As the percentage of patients with renal failure secondary to vascular disease and/or diabetes mellitus is rapidly growing, and the underlying disease per se may also influence the arterial wall properties, it may also be of interest to study the arterial wall properties in relation to the etiology of kidney disease. Methods: The distensibility coefficient (DC) of the common carotid artery was used as a marker of arterial stiffness. One hundred and seventeen patients were studied: 47 patients (aged 63 ± 10 years) with renal failure secondary to vascular disease and/or diabetes mellitus and 70 patients (aged 57 ± 13 years) with other diagnoses. The origin of the renal failure was retrieved from the patients' charts. Results: Age, mean arterial pressure, and serum calcium level were each independent predictors of arterial stiffness (DC). The DC was significantly lower in the patients with vascular renal disease or diabetes mellitus [11.0 ± 5.5 (1/MPa)] as compared with patients with renal/urological diseases [15.4 ± 7.5 (1/MPa)]. Nevertheless, after correction for potentially confounding variables, the relation between cause of renal disease and DC lost significance in the overall group, but remained significant (p < 0.05) in the younger age groups (≤61 years; median age of the patient group). Conclusions: Age, mean arterial pressure, and serum calcium level were independent predictors of arterial stiffness in our patients with renal failure. Only in younger dialysis patients, the origin of renal failure was an independent predictor of arterial wall stiffness.