Target renal damage: the microvascular associations of increased aortic stiffness in patients with COPD

John, Michelle and Hussain, Samia and Prayle, Andrew and Simms, Rebecca and Cockroft, John R. and Bolton, Charlotte E. (2013) Target renal damage: the microvascular associations of increased aortic stiffness in patients with COPD. Respiratory Research, 14 (31). pp. 1-7. ISSN 1465-9921

[img] PDF - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Available under Licence Creative Commons Attribution.
Download (281kB)

Abstract

Background

Although renal impairment has been described in COPD, there is opportunity to evaluate further to determine nature and consider optimal management. Increased aortic stiffness, as seen in COPD, leads to reduced buffering of pulsatile flow. We hypothesised that urinary albumin creatinine ratio (UACR) would reflect glomerular damage related to aortic stiffness.

Methods

Patients with COPD and controls underwent spirometry, blood pressure, arterial stiffness - aortic pulse wave velocity (PWV) and provided a spot urine sample for UACR, with other renal biomarkers measured.

Results

The UACR was increased in patients (n = 52): 0.80 mg/mmol compared to controls (n = 34): 0.46 mg/mmol, p < 0.05. Aortic PWV was related to log10 UACR in all subjects (r = 0.426, p < 0.001) and COPD patients alone. Aortic PWV was a significant variable for UACR with oxygen saturations, after accounting for potential confounders. Eight subjects (7 patients) reached a defined clinical microalbuminuria threshold, with aortic PWV greater in these patients compared to those patients without, although albuminuria is a continuum. Proximal tubular damage biomarkers, unlike the glomerular marker, were not different between patients and controls.

Conclusions

There is glomerular damage in patients with COPD evidenced by increased UACR, related to increased aortic stiffness. Besides the macrovascular prognostic implications of increased aortic stiffness, the microvascular state in COPD management should be considered.

Item Type: Article
Keywords: Arterial Stiffness, Biomarkers, Haemodynamics, Kidney, Renal, Microvascular
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Respiratory Medicine
Depositing User: Chamberlain, Mr Dick
Date Deposited: 09 May 2014 12:47
Last Modified: 14 Sep 2016 14:55
URI: http://eprints.nottingham.ac.uk/id/eprint/3140

Actions (Archive Staff Only)

Edit View Edit View