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Nephrol Dial Transplant (2002) 17: 965-969
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

How important and how treatable is vascular stiffness as a cardiovascular risk factor in renal failure?

David Goldsmith1,, Robert MacGinley1, Andrew Smith2 and Adrian Covic3

1 Renal Unit, 2 Diabetes Unit, Guy's Hospital, London, UK and 3 Parhon Hospital, Iasi, Romania

Keywords: arterial compliance; arteriosclerosis; cardiovascular mortality; renal failure; vascular function

Introduction

It is possible, with the increasing recognition and repetition of epidemiological data that provide compelling evidence for the appalling toll that cardiovascular (CV) pathology exerts on patients with advanced renal failure, to become both blasé and nihilistic. Dialysis patients aged 20–30 years have the same cardiovascular mortality (CVM) as non-diabetic non-uraemic subjects aged 70–80! Despite the known high prevalence of coronary artery disease in dialysis patients [1], assessment of CV risk relying exclusively on ‘conventional’ CV risk factors incompletely explains these patents' greatly increased mortality rates. Where Framingham CVM risk scores and actual CV events have been compared (in a renal transplant population) it appears that age, diabetes and smoking seem even more detrimental for uraemic subjects than for the general population [2].

With the plethora of candidate mechanisms to explain more severe CV disease in renal patients, from endothelial dysfunction and micro-inflammation, to redox stress, . . . [Full Text of this Article]

Pulse pressure as the most powerful predictor of cardiovascular mortality

Pulse pressure, pulse wave velocity, wave energy reflection and aortic elasticity

How abnormal, large artery structure leads to abnormal arterial function in uraemia

Real and potential therapeutic interventions

Effects of renal transplantation on vascular structure and function

Conclusions

Notes

References


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