Evaluation of arterial stiffness in maintenance hemodialysis patients using pulse wave analysis and serum biomarkers of bone turnover

Background Vascular stiffness is common among patients with end-stage renal disease (ESRD). Circulating markers of bone formation play an important role in evaluating bone-mineral disease state as well as in predicting the risk of developing vascular calcification and hence, arterial stiffness. Aims This study aimed to assess arterial stiffness in maintenance hemodialysis patients using pulse wave analysis as an index of central and peripheral arterial stiffness and serum procollagen type I N-terminal propeptide (P1NP) as a marker for bone turnover. Patients and methods Fifty ESRD patients aged 18 years old or more who have been assigned to regular long-term hemodialysis were included in this study and subjected to complete history taking and physical examination and laboratory investigations including lipid profile, fasting plasma glucose level (mg/dl), serum creatinine, blood urea (mg/dl), serum phosphorus (mg/dl), serum calcium (mg/dl), P1NP (ng/ml), serum parathyroid hormone (PTH) (pg/ml), and serum bone-specific alkaline phosphatase (BALP) (U/l), and aortic pulse wave velocity. Results There was significant positive correlation between P1NP and PTH (P≤0.01) and between BALP and serum PTH (P≤0.01). There was significant difference between patients with low and high augmentation index regarding BALP (P=0.018). Conclusion ESRD patients have a high prevalence of vascular stiffness assessed by pulse wave analysis. There is a significant correlation between BALP and PTH and between P1NP and PTH. There is a relation between markers of bone formation and vascular stiffness.