Age dependence of brachial cuff-based ambulatory PWV in end-stage kidney disease patients undergoing long-term peritoneal dialysis. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Vaios, Vasilios; Georgianos, Panagiotis I; Vareta, Georgia; Divanis, Dimitrios; Dounousi, Evangelia; Eleftheriadis, Theodoros; Papagianni, Aikaterini; Zebekakis, Pantelis E; Liakopoulos, Vassilios
• Is Part Of: Peritoneal dialysis international. Volume 42:Issue 1(2022)
• Page Start: 65
• Page End: 74
• Publication Date: 2022-01
• Subjects: Arterial stiffness -- end-stage kidney disease -- Mobil-O-Graph -- peritoneal dialysis -- pulse wave velocity -- PWV; Peritoneal dialysis -- Periodicals; Continuous ambulatory peritoneal dialysis -- Periodicals; 617.461059
• DOI: 10.1177/0896860821996927
• Languages: English
• ISSNs: 0896-8608

Abstract

Background: The newly introduced device Mobil-O-Graph (IEM, Stolberg, Germany) combines brachial cuff oscillometry and pulse wave analysis, enabling the determination of pulse wave velocity (PWV) via complex mathematic algorithms during 24-h ambulatory blood pressure monitoring (ABPM). However, the determinants of oscillometric PWV in the end-stage kidney disease (ESKD) population remain poorly understood. Methods: In this study, 81 ESKD patients undergoing long-term peritoneal dialysis underwent 24-h ABPM with the Mobil-O-Graph device. The association of 24-h oscillometric PWV with several demographic, clinical and haemodynamic parameters was explored using linear regression analysis. Results: In univariate analysis, among 21 risk factors, 24-h PWV exhibited a positive relationship with age, body mass index, overhydration assessed via bioimpedance spectroscopy, diabetic status, history of dyslipidaemia and coronary heart disease, and it had a negative relationship with female sex and 24-h heart rate. In stepwise multivariate analysis, age ( β : 0.883), 24-h systolic blood pressure (BP) ( β : 0.217) and 24-h heart rate ( β : −0.083) were the only three factors that remained as independent determinants of 24-h PWV (adjusted R 2 = 0.929). These associations were not modified when all 21 risk factors were analysed conjointly or when the model included only variables shown to be significant in univariate comparisons. Conclusion: The present study shows that age together with simultaneously assessed oscillometric BP and heart rate are the major determinants of Mobil-O-Graph-derived PWV, explaining >90% of the total variation of this marker. This age dependence of oscillometric PWV limits the validity of this marker to detect the premature vascular ageing, a unique characteristic of vascular remodelling in ESKD.