Arterial Stiffness in CKD: A Review

Abstract

This narrative review summarizes a decade of experience examining the cross-sectional and longitudinal relationships of arterial stiffness, as assessed using carotid-femoral pulse wave velocity, with outcomes in patients with chronic kidney disease enrolled in the Chronic Renal Insufficiency Cohort. Our goal is to review the importance of the pulse wave contour and pulse wave velocity and present data on the reproducibility of pulse wave velocity measurements, determinants of pulse wave velocity, and the relationship that velocity measurements have with longitudinal kidney and cardiovascular outcomes. Measures of arterial stiffness have contributed substantially to our understanding of mechanisms of cardiovascular disease, kidney disease progression, and all-cause mortality. Given the independent relationship of arterial stiffness to a variety of outcomes, it is our hope that future developments in behavioral, nutritional, and pharmacologic approaches to vascular destiffening will provide interventions that benefit patients with chronic kidney diseases.