Creatinine clearance, pulse wave velocity, carotid compliance and essential hypertension

Background. The vascular hallmark of subjects with endstage renal disease is increased arterial stiffness independent of blood pressure. wall stress, and cardiovascular risk factors such as hypertension, plasma glucose and cholesterol, obesity, and tobacco consumption. Whether arterial stiffness and kidney function ale statistically associated in subjects with plasma creatinine less than or equal to 130 mu mol/L has not yet been determined. Material. In 1290 subjects with normal or elevated blood pressure values and plasma creatinine less than or equal to 130 mu mol/L, subjects were divided into three tertiles according to the calculated creatinine clearance. Blood pressure aortic pulse wave velocity (PWV), and standard cardiovascular risk factors were determined in parallel. In 112 of the hypertensive subjects, common carotid and radial artery structure: and function (high-resolution echo-Doppler techniques) also were measured. Results. From the 1290 subjects, only the low-tertile group presented a significant negative association between PWV and creatinine clearance independently of blood pressure and standard risk factors. This association was stronger in subjects less than or equal to 55 years of age. In the 112 hypertensive subjects, carotid compliance was positivsly correlated to creatinine clearance even after all adjustment for age, gender. and blood pressure. At less than 55 of the variance of carotid compliance. Such findings were not observed for radial artery compliance. Conclusion. Increased stiffness of central arteries is statistically associated with reduced creatinine clearance in subjects With mild-to-moderate renal insufficiency, indicating that kidney alterations may interact not only with small but also large arteries, and this is independent of age, blood pressure. and standard risk factors.