Arterijų standumo ir kitų biožymenų prognostinė reikšmė vertinant kraujagyslių remodeliaciją ir kardiovaskulinę riziką tarp pakaitine inkstų terapija gydomų pacientų

The crosstalk between cardiovascular system and kidney is very complex. Vascular remodeling in kidney failure eventually leads to arterial stiffening and promotes accelerated arterial aging. Traditional cardiovascular risk factors cannot fully explain the high prevalence of cardiovascular disease in chronic kidney disease (CKD). Arterial stiffening is a variable which significantly improves the cardiovascular risk prediction and represents the overall status of elastic and muscular arteries in CKD. The aim of this work was to establish the evolution and clinical significance of different arterial stiffness parameters in predicting vascular calcification and cardiovascular events in end-stage renal disease and after kidney transplantation. A single-center observational longitudinal study from December 2014 to July 2017 was accomplished. One part of the study focused on CKD stage 5D patients (n=101), the other – on patients before and after kidney transplantation (n=37). All selected participants had no previous history of cardiovascular (CVE), cerebrovascular events or peripheral artery disease. Study subjects were interviewed underwent blood tests, chest X-ray and PWV measurements at the beginning of the study and after different observation periods. During two years follow-up we observed that calculated PWV ratio can predict the extent of vascular calcification and is not associated with CVE in chronic dialysis patients; hemodialysis is related to aortic stiffness progression and brachial arterial stiffness regression; and aortic but not brachial arterial stiffness decrease follows successful kidney transplantation.