Arterial stiffness in black African ancestry patients with chronic kidney disease living in Cameroon

Chronic kidney disease (CKD) is a growing worldwide public health challenge and represents a major cause of death, with the fastest increase over the last two decades (1)]. Among the determinants of high mortality rate in CKD patients, cardiovascular disease (CVD) accounts for up to 50% of all deaths (1,2). The high burden of CVD in CKD patients was ascribed to both conventional cardiovascular (CV) risk factors such as age, hypertension, diabetes, obesity, smoking, and dyslipidemia; and non-traditional or emerging risk factors which include arterial stiffness (AS) (3). Structural and functional changes in arteries are important features of CVD (4). The process of CV damage starts very early during CKD progression, long before end-stage renal disease (ESRD) is reached (1). Increased AS corresponds to damage of large arteries and was shown to be a significant predictive factor of all-cause and CV mortality in different populations (5), including patients with ESRD (3,6-8). Moreover, increased pulse wave velocity (PWV), which is the gold standard measure of AS (9), was shown to contribute to all-cause (5,7) and CV mortality in ESRD patients (6-8). PWV is linked to arterial wall structure and function, and is essentially influenced by age-related changes, blood pressure (BP) and other pathologic states such as CKD (4,6-8). Several mechanisms including those related to CKD have been suggested to be involved in accelerated vessel stiffening (3,8,10-13). Identified factors associated with increasing PWV in non-dialysed CKD patients are age, black ethnicity, male gender, hypertension and diabetes mellitus (13-16). Evidence indicates that stiffening of the aorta may decrease in patients on maintenance dialysis (17)