Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients

<b>Background/Objectives</b>: Cardiovascular disease is the main cause of morbidity and mortality in Chronic Kidney Disease (CKD), so it is of great importance to find simple and non-invasive tools to detect vascular damage in pre-dialysis CKD patients. This study aimed to assess the app...

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Main Authors: Julia Martín-Vírgala, Beatriz Martín-Carro, Sara Fernández-Villabrille, Belinda Fernández-Mariño, Elena Astudillo-Cortés, Minerva Rodríguez-García, Carmen Díaz-Corte, José Luis Fernández-Martín, Carlos Gómez-Alonso, Adriana S. Dusso, Cristina Alonso-Montes, Manuel Naves-Díaz, Sara Panizo, Natalia Carrillo-López
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/3/621
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author Julia Martín-Vírgala
Beatriz Martín-Carro
Sara Fernández-Villabrille
Belinda Fernández-Mariño
Elena Astudillo-Cortés
Minerva Rodríguez-García
Carmen Díaz-Corte
José Luis Fernández-Martín
Carlos Gómez-Alonso
Adriana S. Dusso
Cristina Alonso-Montes
Manuel Naves-Díaz
Sara Panizo
Natalia Carrillo-López
author_facet Julia Martín-Vírgala
Beatriz Martín-Carro
Sara Fernández-Villabrille
Belinda Fernández-Mariño
Elena Astudillo-Cortés
Minerva Rodríguez-García
Carmen Díaz-Corte
José Luis Fernández-Martín
Carlos Gómez-Alonso
Adriana S. Dusso
Cristina Alonso-Montes
Manuel Naves-Díaz
Sara Panizo
Natalia Carrillo-López
author_sort Julia Martín-Vírgala
collection DOAJ
description <b>Background/Objectives</b>: Cardiovascular disease is the main cause of morbidity and mortality in Chronic Kidney Disease (CKD), so it is of great importance to find simple and non-invasive tools to detect vascular damage in pre-dialysis CKD patients. This study aimed to assess the applicability of non-invasive techniques to evaluate vascular damage in stages CKD-2 to CKD-5 and its progression after an 18-month follow-up using (A) carotid–femoral pulse wave velocity (PWV) to assess aortic stiffness and (B) Superb Microvascular Imaging (SMI) ultrasound to assess adventitial neovascularization compared with other traditional techniques to evaluate vascular damage, such as carotid intima–media thickness and Kauppila index. <b>Methods</b>: The study involved 43 CKD patients in stages CKD-2 to CKD-5 and a group of 38 sex- and age-matched controls, studied at baseline and at an 18-month follow-up. Age, sex, body mass index, arterial pressure, pharmacological treatments, and blood and urinary parameters were collected. Aortic stiffness was determined by carotid–femoral PWV and abdominal aortic calcification was assessed in lateral lumbar X-rays and quantified by the Kauppila index. Carotid intima–media thickness (cIMT), the number of carotid plaques, and adventitial neovascularization were evaluated by SMI. <b>Results:</b> Vascular impairment was mostly detected in CKD-4 and CKD-5 stages, with increased aortic stiffness measured by PWV and increased carotid plaques and adventitial neovascularization measured by SMI ultrasound. Furthermore, CKD-5 patients showed greater abdominal aortic calcification. Interestingly, CKD patients displayed a negative correlation between serum soluble Klotho (sKlotho) and cIMT. Finally, CKD patients showed no progression of vascular impairment after the 18-month follow-up, with the exception of carotid plaques. <b>Conclusions</b>: Performing non-invasive PWV and SMI ultrasound might be useful to evaluate vascular damage in CKD before entering dialysis, possibly helping to prevent cardiovascular events, although future studies should clarify the use of these techniques in clinical practice.
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spelling doaj-art-e7d37dca9e2148af80350311c802f3882025-08-20T02:11:25ZengMDPI AGBiomedicines2227-90592025-03-0113362110.3390/biomedicines13030621Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis PatientsJulia Martín-Vírgala0Beatriz Martín-Carro1Sara Fernández-Villabrille2Belinda Fernández-Mariño3Elena Astudillo-Cortés4Minerva Rodríguez-García5Carmen Díaz-Corte6José Luis Fernández-Martín7Carlos Gómez-Alonso8Adriana S. Dusso9Cristina Alonso-Montes10Manuel Naves-Díaz11Sara Panizo12Natalia Carrillo-López13Metabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainÁrea de Radiodiagnóstico, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainUnidad de Gestión Clínica de Nefrología, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainRICORS 2040-RENAL, 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainDivision of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110, USAMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, SpainMetabolismo Óseo, Vascular y Enfermedades Inflamatorias Crónicas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain<b>Background/Objectives</b>: Cardiovascular disease is the main cause of morbidity and mortality in Chronic Kidney Disease (CKD), so it is of great importance to find simple and non-invasive tools to detect vascular damage in pre-dialysis CKD patients. This study aimed to assess the applicability of non-invasive techniques to evaluate vascular damage in stages CKD-2 to CKD-5 and its progression after an 18-month follow-up using (A) carotid–femoral pulse wave velocity (PWV) to assess aortic stiffness and (B) Superb Microvascular Imaging (SMI) ultrasound to assess adventitial neovascularization compared with other traditional techniques to evaluate vascular damage, such as carotid intima–media thickness and Kauppila index. <b>Methods</b>: The study involved 43 CKD patients in stages CKD-2 to CKD-5 and a group of 38 sex- and age-matched controls, studied at baseline and at an 18-month follow-up. Age, sex, body mass index, arterial pressure, pharmacological treatments, and blood and urinary parameters were collected. Aortic stiffness was determined by carotid–femoral PWV and abdominal aortic calcification was assessed in lateral lumbar X-rays and quantified by the Kauppila index. Carotid intima–media thickness (cIMT), the number of carotid plaques, and adventitial neovascularization were evaluated by SMI. <b>Results:</b> Vascular impairment was mostly detected in CKD-4 and CKD-5 stages, with increased aortic stiffness measured by PWV and increased carotid plaques and adventitial neovascularization measured by SMI ultrasound. Furthermore, CKD-5 patients showed greater abdominal aortic calcification. Interestingly, CKD patients displayed a negative correlation between serum soluble Klotho (sKlotho) and cIMT. Finally, CKD patients showed no progression of vascular impairment after the 18-month follow-up, with the exception of carotid plaques. <b>Conclusions</b>: Performing non-invasive PWV and SMI ultrasound might be useful to evaluate vascular damage in CKD before entering dialysis, possibly helping to prevent cardiovascular events, although future studies should clarify the use of these techniques in clinical practice.https://www.mdpi.com/2227-9059/13/3/621adventitial neovascularizationaortic stiffnessnon-invasivepulse wave velocitysuperb microvascular imaging
spellingShingle Julia Martín-Vírgala
Beatriz Martín-Carro
Sara Fernández-Villabrille
Belinda Fernández-Mariño
Elena Astudillo-Cortés
Minerva Rodríguez-García
Carmen Díaz-Corte
José Luis Fernández-Martín
Carlos Gómez-Alonso
Adriana S. Dusso
Cristina Alonso-Montes
Manuel Naves-Díaz
Sara Panizo
Natalia Carrillo-López
Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
Biomedicines
adventitial neovascularization
aortic stiffness
non-invasive
pulse wave velocity
superb microvascular imaging
title Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
title_full Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
title_fullStr Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
title_full_unstemmed Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
title_short Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients
title_sort non invasive assessment of vascular damage through pulse wave velocity and superb microvascular imaging in pre dialysis patients
topic adventitial neovascularization
aortic stiffness
non-invasive
pulse wave velocity
superb microvascular imaging
url https://www.mdpi.com/2227-9059/13/3/621
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