Early arterial stiffness and inflammatory bio-markers in normotensive polycystic kidney disease patients

Am J Nephrol. 2012;36(1):11-8. doi: 10.1159/000339440. Epub 2012 Jun 13.

Abstract

Background/aims: Cardiovascular disease is the main cause of morbidity and mortality in autosomal-dominant polycystic kidney disease (ADPKD) patients. To clarify temporal relationship between ADPKD, hypertension and the loss of renal function, we examined these factors in patients with early-stage ADPKD who did not yet have hypertension.

Methods: Fifty patients with ADPKD (42% males, 36.6 ± 9.9 years, no blood pressure medication) and 50 healthy controls (44% males, 35.4 ± 6.4 years) were studied cross-sectionally. Pulse wave velocity (PWV), cardiac morphology and function, aortic elastic indexes, estimated glomerular filtration rate (eGFR), 24-hour ambulatory blood pressure, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and highly sensitive C-reactive protein (hs-CRP) were measured in all participants, using conventional methods.

Results: Despite a normal blood pressure, aortic stiffness index and pulse wave velocity values were increased in patients compared to controls (6.8 ± 4.7 vs. 5.1 ± 3.3, p = 0.043 and 9.6 ± 1.3 vs. 5.8 ± 1.1 m/s, p < 0.001). In univariate analysis, IL-6, TNF-α, hs-CRP and eGFR were all significantly correlated with PWV. The independence of these correlations were analyzed in a regression model, and showed PWV to be significantly predicted by IL-6, TNF-α and hs-CRP.

Conclusion: Increased arterial stiffness and pulse wave velocity are early manifestations of ADPKD appearing before hypertension or reduced eGFR. However, these vascular abnormalities are related to signs of systemic low grade inflammation, suggesting a common pathophysiological mechanism apparently present also in other vascular diseases but yet to be elucidated.

MeSH terms

  • Adult
  • Aged
  • Arteries / pathology
  • Biomarkers / metabolism*
  • Blood Pressure
  • C-Reactive Protein / metabolism
  • Echocardiography / methods
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / pathology
  • Inflammation
  • Interleukin-6 / metabolism
  • Kidney Diseases / metabolism
  • Male
  • Middle Aged
  • Polycystic Kidney Diseases / blood*
  • Polycystic Kidney Diseases / diagnosis*
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Biomarkers
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein