06.06 Arterial Stiffness and Enlargement in Mild to Moderate Chronic Renal Failure: Role of Vitamin D

Abstract

Background

Chronic kidney disease (CKD) is associated with arterial abnormalities characterized by an increase in arterial stiffness and an enlargement of carotid artery. Non classical cardiovascular risk factors such as abnormalities of mineral metabolism are associated with an increase risk in cardiovascular disease in end stage renal disease patients. The aim of this cross-sectional study is to evaluate the relationship between arterial phenotype and mineral metabolism parameters, serum parathormone (PTH), 25(OH) vitamin D and 1.25(OH)₂ vitamin D, in 95 CKD patients (58.4 ± 14.9 years, GFR ⁵¹Cr-EDTA 36 ± 16mL/min/1.73m²).

Methods

Common carotid artery diameter, intima-media thickness, carotid stiffness, Young’s elastic modulus were determined with an echotracking system. Aortic stiffness was evaluated by the measurement of carotid-to-femoral pulse wave velocity (Complior^R).

Results

After adjustment for mean blood pressure, age and GFR, 25 (OH) vitamin D level is significantly and negatively correlated with carotid stiffness (P = 0.005) and Young elastic modulus (P = 0.003) and explains respectively 4.1% and 5.3% of the variance. After adjustment for mean blood pressure, age and GFR, 1.25(OH)₂ vitamin D level is significantly and positively correlated with carotid diameter (P = 0.002), with carotid stiffness (P = 0.03) and young elastic modulus (P = 0.04). PTH is significantly and negatively correlated with aortic stiffness (P = 0.01) and explains 3.7% of the variance.

Conclusion

Vitamin D status is associated with an increase in arterial stiffness and enlargement in mild to moderate chronic renal failure, 25 (OH) D3 is associated with favourable arterial phenotype whereas 1.25(OH)₂ D3 and PTH are associated with adverse arterial phenotype.