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Kidney Int Suppl (2011). 2011 Jun;1(1):10-12.

Arterial aging and arterial disease: interplay between central hemodynamics, cardiac work, and organ flow-implications for CKD and cardiovascular disease.

Author information

1
INSERM U970, Hôpital Européen Georges Pompidou , Paris, France.
2
Clinic of Nephrology, C.I. Parhon University Hospital, Gr. T. Popa University of Medicine and Pharmacy , Iasi, Romania.
3
Renal Unit, Guy's and St Thomas' NHS Foundation Hospital, King's Health Partners , London, UK.
4
Division of Internal Medicine and Nephrology, Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia , Katowice, Poland.
5
Nephrology Division, Department of Medicine, Akdeniz University Medical School , Antalya, Turkey.
6
Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo , Madrid, Spain.
7
INSERM ERI-12 (EA 4292) , Amiens, France ; Amiens University Hospital and the Jules Verne University of Picardie , Amiens, France.
8
Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm, Sweden.
9
Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona, Spain.
10
Department of Internal Medicine IV, Saarland University Medical Centre , Homburg/Saar, Germany.
11
Indiana University and VAMC , Indianapolis, Indiana, USA.
12
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands.
13
Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, The Netherlands.
14
Department of Nephrology, University Medical Center , Utrecht, The Netherlands.
15
Nephrology, Dialysis and Transplantation Unit and CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension , Reggio Calabria, Italy.

Abstract

Cardiovascular disease is an important cause of morbidity and mortality in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). All epidemiological studies have clearly shown that accelerated arterial and cardiac aging is characteristic of these populations. Arterial premature aging is heterogeneous. It principally involves the aorta and central capacitive arteries, and is characterized by preferential aortic stiffening and disappearance of stiffness/impedance gradients between the central and peripheral arteries. These changes have a double impact: on the heart, upstream, with left ventricular hypertrophy and decreased coronary perfusion; and, downstream, on renal and brain microcirculation (decrease in glomerular filtration and cognitive functions). Multifactorial at origin, the pathophysiology of aortic 'progeria' and microvascular disorders in CKD/ESRD is not well understood and should be the focus of interest in future studies.

KEYWORDS:

aging; arterial stiffness; arteriosclerosis; end-stage renal disease; pressure waves

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