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Arterial stiffness in end-stage renal disease-pathogenesis, clinical epidemiology, and therapeutic potentials.

ΤίτλοςArterial stiffness in end-stage renal disease-pathogenesis, clinical epidemiology, and therapeutic potentials.
Publication TypeJournal Article
Year of Publication2018
AuthorsGeorgianos, P. I., Pikilidou M. I., Liakopoulos V., Balaskas E. V., & Zebekakis P. E.
JournalHypertens Res
Volume41
Issue5
Pagination309-319
Date Published2018 May
ISSN1348-4214
Λέξεις κλειδιάAntihypertensive Agents, Arteriosclerosis, Disease Progression, Glycation End Products, Advanced, Humans, Kidney Failure, Chronic, Vascular Stiffness
Abstract

Arterial stiffness is an important risk factor for cardiovascular morbidity and mortality in patients with end-stage renal disease (ESRD). Arterial stiffness aggravates cardiovascular risk via multiple pathways, such as augmentation of aortic systolic pressure, subendocardial hypoperfusion, and excess pulsatile energy transmission from macro- to microcirculation. Pathogenesis of the arteriosclerotic process in ESRD is complex and not yet fully understood. Several factors unique to ESRD, such as mineral metabolism disturbances, vascular calcifications, formation of advanced glycation end-products, and acute and chronic volume overload, are proposed to play a particular role in the progression of arteriosclerosis in ESRD. As these and other mechanistic pathways of arterial stiffening in ESRD are elucidated, there is hope that this knowledge will be translated into novel therapeutic interventions targeting arterial stiffness. In the meantime, blood pressure (BP) lowering via strict volume control and appropriate use of antihypertensive drugs is a fundamental step in reversing accelerated arterial stiffening and modifying the cardiovascular risk profile of ESRD patients. In this article, we review the pathogenesis, clinical epidemiology, and therapies targeting arterial stiffness in ESRD, discussing recent advances and high-priority goals of future research in these important areas.

DOI10.1038/s41440-018-0025-5
Alternate JournalHypertens Res
PubMed ID29531291

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