2020, Number 3
<< Back Next >>
Rev Nefrol Dial Traspl 2020; 40 (3)
Systemic vasculature in chronic kidney disease. third part
Inserra F, Lavenia G, Forcada P, Castellaro BC
Language: Spanish
References: 70
Page: 251-267
PDF size: 338.87 Kb.
ABSTRACT
In this literature review we present various
therapeutic alternatives for vascular stiffness
in patients with chronic kidney disease. Here
we discussed the role of non-pharmacological
treatments with evidence of the benefit of
sodium restriction on vascular stiffness, the
positive effects in that sense shown by the
Mediterranean diet, and the small benefits of
physical activity on vascular stiffness in this
group of patients. Is in the pharmacological
treatment where the best benefits are evidenced;
both, on vascular stiffness and on the associated
cardiovascular events.
The effectiveness of renin-angiotensinaldosterone
system inhibitors and antialdosteronic
drugs to decrease blood pressure and stiffness
has been widely demonstrated. Other drugs,
such as endothelin receptor blockers, showed
their protective effects on the arterial wall, but
with potential adverse effects.
This article also reviews the effects of new
anti-diabetic drugs, iSLGT2 and aGLP-1 in
particular, and their effect on blood pressure
and vascular stiffness, particularly in patients
with chronic kidney disease. The utility of
drugs with effects on the inflammatory cascade
and drugs with a potential effect on vascular
calcification, complication occurring frequently
during renal function replacement treatment,
are also reviewed.
In short, this work focuses in the therapeutic
interventions on arterial stiffness, with emphasis
on the reduction of cardiovascular events and
mortality in patients with chronic kidney
disease.
REFERENCES
Inserra F, Castellaro Bello C. La vasculatura sistémicaen la enfermedad renal crónica. Primera parte. RevNefrol Dial Traspl. 2019;39(4):279-90.
Inserra F, Lavenia G, Forcada P, Castellaro Bello C. Lavasculatura sistémica en la enfermedad renal crónica.Segunda parte. Rev Nefrol Dial Traspl. 2020;40(1):62-75.
Blacher J, Safar ME, Guerin AP, Pannier B, MarchaisSJ, London GM. Aortic pulse wave velocity indexand mortality in end-stage renal disease. KidneyInt. 2003;63(5):1852-60. doi: 10.1046/j.1523-1755.2003.00932.x.
Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME,London GM. Impact of aortic stiffness on survival inend-stage renal disease. Circulation. 1999;99(18):2434-9. doi: 10.1161/01.cir.99.18.2434.
Salvi P, Giannattasio C, Parati G. High sodium intakeand arterial stiffness. J Hypertens. 2018;36(4):754-8.doi: 10.1097/HJH.0000000000001658.
Saran R, Padilla RL, Gillespie BW, Michael HeungM, Hummel SL, Derebail VK, et al. A Randomizedcrossover trial of dietary sodium restriction in stage3-4 CKD. Clin J Am Soc Nephrol. 2017;12(3):399-407.doi:10.2215/CJN.01120216.
D‘Elia L, Galletti F, La Fata E, Sabino P, Strazzullo P.Effect of dietary sodium restriction on arterial stiffness:systematic review and meta-analysis of the randomizedcontrolled trials. J Hypertens. 2018;36(4):734-43. doi:10.1097/HJH.0000000000001604.
Siriopol D, Covic A, Iliescu R, Kanbay M, Tautu O,Radulescu L, et al. Arterial stiffness mediates the effectof salt intake on systolic blood pressure. J Clin Hypertens.2018;20(11):1587-94. doi: 10.1111/jch.13399.
Valtuille R. Potential novel benefits of sodium restrictionin chronic kidney disease [published online ahead ofprint, 2020 Jun 15]. Curr Hypertens Rev. 2020;10. doi:10.2174/1573402116666200615152139.
Jennings A, Berendsen AM, de Groot LCPGM, FeskensEJM, Brzozowska A, Sicinska E, et al. Mediterraneanstylediet improves systolic blood pressure and arterialstiffness in older adults. Hypertension. 2019;73(3):578-86. doi: 10.1161/HYPERTENSIONAHA.118.12259.
Chauveau P, Aparicio M, Bellizzi V, Campbell K,Hong X, Johansson L, et al. Mediterranean diet as thediet of choice for patients with chronic kidney disease.Nephrol Dial Transplant. 2018;33(5):725-35. doi:10.1093/ndt/gfx085.
Van Craenenbroeck AH, Van Craenenbroeck EM, VanAckeren K, Vrints CJ, Conraads VM, Verpooten GA,et al. Effect of moderate aerobic exercise training onendothelial function and arterial stiffness in CKD stages3-4: a randomized controlled trial. Am J Kidney Dis.2015;66(2):285-96. doi: 10.1053/j.ajkd.2015.03.015.
Koh KP, Fassett RG, Sharman JE, Coombes JS,Williams AD. Effect of intradialytic versus homebasedaerobic exercise training on physical functionand vascular parameters in hemodialysis patients: arandomized pilot study. Am J Kidney Dis. 2010;55(1):88-99. doi: 10.1053/j.ajkd.2009.09.025.
Mallamaci F, Pisano A, Tripepi G. Physical activity inchronic kidney disease and the EXerCise Introduction ToEnhance trial. Nephrol Dial Transplant. 2020;35(Suppl.2):ii18-ii22. doi: 10.1093/ndt/gfaa012.
Guerin AP, Blacher J, Pannier B, Marchais SJ, SafarME, London GM. Impact of aortic stiffness attenuationon survival of patients in end-stage renal failure.Circulation. 2001;103(7):987-92. doi: 10.1161/01.cir.103.7.987.
Pickup L, Radhakrishnan A, Townend JN, FerroCJ. Arterial stiffness in chronic kidney disease: amodifiable cardiovascular risk factor? Curr OpinNephrol Hypertens. 2019;28(6):527-36. doi: 10.1097/MNH.0000000000000535.
Morgan T, Lauri J, Bertram D, Anderson A. Effectof different antihypertensive drug classes on centralaortic pressure. Am J Hypertens. 2004;17(2):118-23. doi:10.1016/j.amjhyper.2003.09.012.
Mallareddy M, Parikh CR, Peixoto AJ. Effect ofangiotensin-converting enzyme inhibitors on arterialstiffness in hypertension: systematic review and metaanalysis.J Clin Hypertens (Greenwich). 2006;8(6):398-403. doi: 10.1111/j.1076-7460.2006.05418.x.
Shahin Y, Khan JA, Chetter I. Angiotensinconverting enzyme inhibitors effect on arterialstiffness and wave reflections: a meta-analysis andmeta-regression of randomised controlled trials.Atherosclerosis. 2012;221(1):18-33. doi: 10.1016/j.atherosclerosis.2011.12.005.
Georgianos PI, Sarafidis PA, Lasaridis AN. Arterialstiffness: a novel cardiovascular risk factor in kidneydisease patients. Curr Vasc Pharmacol. 2015;13(2):229-38. doi: 10.2174/15701611113119990147.
Georgianos PI, Pikilidou MI, Liakopoulos V, BalaskasEV, Zebekakis PE. Arterial stiffness in end-stagerenal disease-pathogenesis, clinical epidemiology, andtherapeutic potentials. Hypertens Res. 2018;41(5):309-19. doi: 10.1038/s41440-018-0025-5.
Edwards NC, Steeds RP, Stewart PM, Ferro CJ,Townend JN. Effect of spironolactone on left ventricularmass and aortic stiffness in early-stage chronic kidneydisease: a randomized controlled trial. J Am Coll Cardiol.2009;54(6):505-12. doi: 10.1016/j.jacc.2009.03.066.
Chirinos JA, Sardana M, Syed AA, Koppula MR,Varakantam S, Vasim I, et al. Aldosterone, inactivematrix gla-protein, and large artery stiffness inhypertension. J Am Soc Hypertens. 2018;12(9):681-9.doi: 10.1016/j.jash.2018.06.018.
Bramlage P, Swift SL, Thoenes M, Minguet J, FerreroC, Schmieder RE. Non-steroidal mineralocorticoidreceptor antagonism for the treatment of cardiovascularand renal disease [published correction appears in EurJ Heart Fail. 2017 Jun;19(6):811]. Eur J Heart Fail.2016;18(1):28-37. doi: 10.1002/ejhf.444.
Gil-Ortega M, Vega-Martín E, Martín-Ramos M,González-Blázquez R, Pulido-Olmo H, Ruiz-HurtadoG, et al. Finerenone reduces intrinsic arterial stiffness inMunich Wistar frömter rats, a genetic model of chronickidney disease. Am J Nephrol. 2020;51(4):294-303. doi:10.1159/000506275.
Pitt B, Filippatos G, Gheorghiade M, Kober L,Krum H, Ponikowski P, et al. Rationale and designof ARTS: a randomized, double-blind study of BAY94-8862 in patients with chronic heart failure and mildor moderate chronic kidney disease. Eur J Heart Fail.2012;14(6):668-75. doi: 10.1093/eurjhf/hfs061.
Bakris GL, Agarwal R, Chan JC, Cooper ME,Gansevoort RT, Haller H, et al. Effect of finerenone onalbuminuria in patients with diabetic nephropathy: arandomized clinical trial. JAMA. 2015;314(9):884-94.doi: 10.1001/jama.2015.10081.
Agabiti-Rosei E, Mancia G, O’Rourke MF, RomanMJ, Safar ME, Smulyan H, et al. Central bloodpressure measurements and antihypertensive therapy. Aconsensus document. Hypertension. 2007;50(1):154-60.doi: 10.1161/HYPERTENSIONAHA.107.090068.
Koumaras C, Tziomalos K, Stavrinou E, KatsikiN, Athyros VG, Mikhailidis DP, et al. Effects ofrenin-angiotensin-aldosterone system inhibitorsand beta-blockers on markers of arterial stiffness. JAm Soc Hypertens. 2014;8(2):74-82. doi: 10.1016/j.jash.2013.09.001.
Dahlöf B, Sever PS, Poulter NR, Wedel H, BeeversD, Caulfield M, et al. Prevention of cardiovascularevents with an antihypertensive regimen ofamlodipine adding perindopril as required versusatenolol adding bendroflumethiazide as required, inthe Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA):a multicentre randomised controlled trial. Lancet.2005;366(9489):895-906. doi: 10.1016/S0140-6736(05)67185-1.
Bakris GL, Sarafidis PA, Weir MR, Dahlöf B, Pitt B,Jamerson K, et al. Renal outcomes with different fixeddosecombination therapies in patients with hypertensionat high risk for cardiovascular events (ACCOMPLISH):a prespecified secondary analysis of a randomisedcontrolled trial. Lancet. 2010;375(9721):1173-81. doi:10.1016/S0140-6736(09)62100-0.
Larivière R, Gauthier-Bastien A, Ung RV, St-HilaireJ, Mac-Way F, Richard DE, et al. Endothelin type Areceptor blockade reduces vascular calcification andinflammation in rats with chronic kidney disease.J Hypertens. 2017;35(2):376-84. doi: 10.1097/HJH.0000000000001161.
Heerspink HJL, Parving HH, Andress DL, BakrisG, Correa-Rotter R, Hou F-F, et al. Atrasentan andrenal events in patients with type 2 diabetes andchronic kidney disease (SONAR): a double-blind,randomised, placebo-controlled trial [publishedcorrection appears in Lancet. 2019;393(10184):1936].Lancet. 2019;393(10184):1937-47. doi: 10.1016/S0140-6736(19)30772-X.
Patoulias D, Papadopoulos C, Stavropoulos K,Zografou I, Doumas M, Karagiannis A. Prognosticvalue of arterial stiffness measurements in cardiovasculardisease, diabetes, and its complications: The potentialrole of sodium-glucose co-transporter-2 inhibitors. JClin Hypertens (Greenwich). 2020;22(4):562-71. doi:10.1111/jch.13831.
Bosch A, Ott C, Jung S, Striepe K, Karg MV,Kannenkeril D, et al. How does empagliflozin improvearterial stiffness in patients with type 2 diabetes mellitus?Sub analysis of a clinical trial. Cardiovasc Diabetol.2019;18(1):44. doi: 10.1186/s12933-019-0839-8.
Batzias K, Antonopoulos AS, Oikonomou E, SiasosG, Bletsa E, Stampouloglou PK, et al. Effects ofnewer antidiabetic drugs on endothelial functionand arterial stiffness: a systematic review and meta-Analysis. J Diabetes Res. 2018;2018:1232583. doi:10.1155/2018/1232583.
Ng P, Stringer SJ, Jesky MD, Yadav P, Athwal R, DuttonM, et al. Allopurinol is an independent determinant ofimproved arterial stiffness in chronic kidney disease: across-sectional study. PLoS One. 2014;9(3):e91961. doi:10.1371/journal.pone.0091961.
Tausche AK, Christoph M, Forkmann M, RichterU, Kopprasch S, Bielitz C, et al. As compared toallopurinol, urate-lowering therapy with febuxostathas superior effects on oxidative stress and pulse wavevelocity in patients with severe chronic tophaceousgout. Rheumatol Int. 2014;34(1):101-9. doi: 10.1007/s00296-013-2857-2.
Robert D. Bordoxolone - the Phoenix. J Am Soc Nephrol.2018;29(2):360-1. doi: 10.1681/ASN.2017121317.
Nowak KL, Chonchol M, Ikizler TA, Farmer-Bailey H,Salas N, Chaudhry R, et al. IL-1 inhibition and vascularfunction in CKD. J Am Soc Nephrol. 2017;28(3):971-80.doi:10.1681/ASN.2016040453.
Coccheri S, Mannello F. Development and useof sulodexide in vascular diseases: implications fortreatment. Drug Des Devel Ther. 2013;8:49-65. doi:10.2147/DDDT.S6762.
Semba RD, Najjar SS, Sun K, Lakatta EG, FerrucciL. Serum carboxymethyl-lysine, an advanced glycationend product, is associated with increased aortic pulsewave velocity in adults. Am J Hypertens. 2009;22(1):74-9. doi: 10.1038/ajh.2008.320.
Stinghen AE, Massy ZA, Vlassara H, Striker GE,Boullier A. Uremic toxicity of advanced glycation endproducts in CKD. J Am Soc Nephrol. 2016;27(2):354-70. doi: 10.1681/ASN.2014101047.
Wei Q, Ren X, Jiang Y, Jin H, Liu N, Li J. Advancedglycation end products accelerate rat vascularcalcification through RAGE/oxidative stress. BMCCardiovasc Disord. 2013;13:13. doi: 10.1186/1471-2261-13-13.
Oudegeest-Sander MH, Olde Rikkert MG, SmitsP, Thijssen DHJ, van Dijk APJ, Levine BD, et al. Theeffect of an advanced glycation end-product crosslinkbreaker and exercise training on vascular function inolder individuals: a randomized factorial design trial.Exp Gerontol. 2013;48(12):1509-17. doi: 10.1016/j.exger.2013.10.009.
Fassett RG, Robertson IK, Ball MJ, Geraghty DP,Sharman JE, Coombes JS. Effects of atorvastatin onarterial stiffness in chronic kidney disease: a randomisedcontrolled trial. J Atheroscler Thromb. 2010;17(3):235-41. doi: 10.5551/jat.2683.
Tonelli M, Wanner C; Kidney Disease: ImprovingGlobal Outcomes Lipid Guideline Development WorkGroup Members. Lipid management in chronic kidneydisease: synopsis of the Kidney Disease: ImprovingGlobal Outcomes 2013 clinical practice guideline. AnnIntern Med. 2014;160(3):182. doi: 10.7326/M13-2453.
Hewitt NA, O‘Connor AA, O‘Shaughnessy DV, ElderGJ. Effects of cholecalciferol on functional, biochemical,vascular, and quality of life outcomes in hemodialysispatients. Clin J Am Soc Nephrol. 2013;8(7):1143-9. doi:10.2215/CJN.02840312.
Marckmann P, Agerskov H, Thineshkumar S, BladbjergE-M, Sidelmann JJ, Jespersen J, et al. Randomizedcontrolled trial of cholecalciferol supplementation inchronic kidney disease patients with hypovitaminosisD. Nephrol Dial Transplant. 2012;27(9):3523-31. doi:10.1093/ndt/gfs138.
Hansen D. A randomised clinical study of alfacalcidoland paricalcitol. Dan Med J. 2012;59(2):B4400.
Giakoumis M, Tsioufis C, Dimitriadis K, SonikianM, Kasiakogias A, Andrikou E, et al. Effects of oralparicalcitol therapy on arterial stiffness and osteopontinin hypertensive patients with chronic kidney diseaseand secondary hyperparathyroidism. Hellenic J Cardiol.2019;60(2):108-13. doi: 10.1016/j.hjc.2017.12.010.
Rodríguez RA, Spence M, Hae R, Agharazii M, Burns KD.Pharmacologic therapies for aortic stiffness in end-stagerenal disease: a systematic review and meta-analysis.Can J Kidney Health Dis. 2020;7:2054358120906974.doi: 10.1177/2054358120906974.
Chow KM, Szeto CC, Kwan BC, Cheng PM, PangWF, Leung CB, et al. Effect of cinacalcet treatmenton vascular arterial stiffness among peritoneal dialysispatients with secondary hyperparathyroidism.Nephrology (Carlton). 2014;19(6):339-44. doi: 10.1111/nep.12223.
Yu L, Tomlinson JE, Alexander ST, Hensley K, HanC, Dwyer D, et al. Etelcalcetide, A Novel Calcimimetic,Prevents Vascular Calcification in A Rat Model of RenalInsufficiency with Secondary Hyperparathyroidism.Calcif Tissue Int. 2017;101(6):641-53. doi:10.1007/s00223-017-0319-7.
Chertow GM, Burke SK, Raggi P; Treat to GoalWorking Group. Sevelamer attenuates the progressionof coronary and aortic calcification in hemodialysispatients. Kidney Int. 2002;62(1):245-52. doi:10.1046/j.1523-1755.2002.00434.x.
Othmane Tel H, Bakonyi G, Egresits J, Fekete BC,Fodor E, Jarai Z, et al. Effect of sevelamer on aortic pulsewave velocity in patients on hemodialysis: a prospectiveobservational study. Hemodial Int. 2007;11(Suppl3):S13-21. doi: 10.1111/j.1542-4758.2007.00224.x.
Qu X, Jin F, Hao Y, Li H, Tang T, Wang H, et al.Magnesium and the risk of cardiovascular events: ameta-analysis of prospective cohort studies. PLoS One.2013;8(3):e57720. doi: 10.1371/journal.pone.0057720.
Del Gobbo LC, Imamura F, Wu JH, de OliveiraOtto MC, Chiuve SE, Mozaffarian D. Circulating anddietary magnesium and risk of cardiovascular disease:a systematic review and meta-analysis of prospectivestudies. Am J Clin Nutr. 2013;98(1):160-73. doi:10.3945/ajcn.112.053132.
Tzanakis IP, Stamataki EE, Papadaki AN, GiannakisN, Damianakis NE, Oreopoulos DG. Magnesiumretards the progress of the arterial calcifications inhemodialysis patients: a pilot study. Int Urol Nephrol.2014;46(11):2199-205. doi: 10.1007/s11255-014-0751-9.
Schlieper G, Westenfeld R, Krüger T, CranenburgEC, Magdeleyns EJ, Brandenburg VM, et al.Circulating nonphosphorylated carboxylated matrix glaprotein predicts survival in ESRD. J Am Soc Nephrol.2011;22(2):387-95. doi: 10.1681/ASN.2010040339.
Pilkey RM, Morton AR, Boffa MB, Noordhof C, DayAG, Su Y, et al. Subclinical vitamin K deficiency inhemodialysis patients. Am J Kidney Dis. 2007;49(3):432-9. doi: 10.1053/j.ajkd.2006.11.041.
Neradova A, Schumacher SP, Hubeek I, Lux P,Schurgers LJ, Vervloet MG. Phosphate binders affectvitamin K concentration by undesired binding, an invitro study. BMC Nephrol. 2017;18(1):149. doi: 10.1186/s12882-017-0560-3.
Aoun M, Makki M, Azar H, Matta H, Chelala DN.High Dephosphorylated-Uncarboxylated MGP inHemodialysis patients: risk factors and response tovitamin K2, A pre-post intervention clinical trial. BMCNephrol. 2017;18(1):191. doi: 10.1186/s12882-017-0609-3.
Himmelfarb J, Stenvinkel P, Ikizler TA, HakimRM. The elephant in uremia: oxidant stress as aunifying concept of cardiovascular disease in uremia.Kidney Int. 2002;62(5):1524-38. doi: 10.1046/j.1523-1755.2002.00600.x.
Mourad A, Carney S, Gillies A, Jones B, Nanra R,Trevillian P. Acute effect of haemodialysis on arterialstiffness: membrane bioincompatibility? Nephrol DialTransplant. 2004;19(11):2797-802. doi: 10.1093/ndt/gfh443.
Chang JH, Yoon SJ, Han SH, Shin SK, Jeon DW,Yang JY, et al. The impact of dialysis modalityon arterial stiffness in patients with end-stagerenal disease. Ren Fail. 2010;32(8):947-53. doi:10.3109/0886022X.2010.502607.
Ghigolea AB, Gherman-Caprioara M, Moldovan AR.Arterial stiffness: hemodialysis versus hemodiafiltration.Clujul Med. 2017;90(2):166-70. doi: 10.15386/cjmed-699.
Rodríguez RA, Hae R, Spence M, Shea B, AgharaziiM, Burns KD. A systematic review and meta-analysisRecibido en su forma original: 27 de junio de 2020Aceptación final: 14 de julio de 2020Dr. Felipe InserraGrupo de Trabajo Hipertensión Arterial y Daño Vascular, Sociedad Argentina de Nefrología,Buenos Aires, ArgentinaORCID: 0000-0002-6671-874Xe-mail: felipe.inserra@gmail.comof nonpharmacologic-based interventions for aorticstiffness in end-stage renal disease. Kidney Int Rep.2019;4(8):1109-21. doi: 10.1016/j.ekir.2019.05.011.
Kaur M, Lal C, Bhowmik D, Jaryal AK, Deepak KK,Agarwal SK. Reduction in augmentation index aftersuccessful renal transplantation. Clin Exp Nephrol.2013;17(1):134-9. doi: 10.1007/s10157-012-0653-z.
Korogiannou M, Xagas E, Marinaki S, SarafidisP, Boletis JN. Arterial stiffness in patients with renaltransplantation; associations with co-morbid conditions,evolution, and prognostic importance for cardiovascularand renal outcomes. Front Cardiovasc Med. 2019;6:67.doi: 10.3389/fcvm.2019.00067.