| Summary: | Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the development of renal cysts related to polycystin mutations in the tubular wall leading to renal failure. Moreover, patients with ADPKD also display early cardiovascular complications including hypertension and aneurysms before the development of renal manifestations. Because an underlying arteriopathy related to the deficit in polycystin which is also present at the vascular level may be involved in these complications, the aim of this study was to evaluate whether arterial stiffness is increased or not in ADPKD patients independently from other cardiovascular risk factors.
We measured carotid-to-femoral pulse wave velocity (PWV, Complior) in 23 ADPKD patients without renal dysfunction (mean age: 42±3 yrs) and 19 control subjects (46±2 yrs) matched for sex, BMI and lipids.
Creatinine clearance was similar in ADPKD patients and controls (Cockcroft: 90±6 vs. 95±6ml/min/1.73m2). Brachial systolic (129±3 vs. 128±3mm Hg) and diastolic (79±2 vs. 81±2mm Hg) blood pressure and the number of treated hypertensive subjects (42% vs. 48%) were similar in ADPKD patients and controls. However, ADPKD patients have higher PWV (9.4±0.3 vs. 8.6±0.3m.s−1, P<0.05). This increase in PWV is still observed in ADPKD patients without treated hypertension as compared to the normotensive controls (9.0±0.3 vs. 7.9±0.1m.s−1, P<0.05).
This study demonstrates that ADPKD patients have an increase in aortic stiffness which is already present before the development of hypertension and renal failure. The impact of arterial stiffening on cardiovascular coupling and on the development of extrarenal complications in ADPKD patients needs further investigations.
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