Brachial-ankle pulse wave velocity predicts silent cerebrovascular diseases in patients with end-stage renal diseases

Aim: cerebrovascular disease (cvd) is a major determinant of the prognosis in end-stage renal diseases (esrd). the purpose of this study was to examine whether factors associated with arterial stiffness contributed to the development of cvd in patients with esrd. methods: cvd (lacunes and carotid/intracranial artery stenosis) was evaluated with brain magnetic resonance imaging (mri),and carotid/intracranial artery magnetic resonance angiography (mra) in 44 pre-dialytic patients. the severity of cvd was evaluated by the number of lacunes and the degree of stenosis,respectively. the association between cvd and atherosclerotic parameters was evaluated. results: patients with severe lacunes (n = 18) manifested older age,lower diastolic blood pressure,serum creatinine and albumin,and higher crp and serum calcium than those with absent-moderate lacunes (n = 26). when assessed by multivariate analysis,only bapwv was adopted as an independent risk factor for severe lacunes. furthermore,bapwv and i-pth were associated with the severity of carotid/intracranial artery stenosis,both of which were independent of other risk factors,including age and diabetes. conclusions: arterial stiffness may constitute a novel determinant predicting the severity of cvd in pre-dialytic patients besides classical risk factors.