Open AccessAltered vascular function in chronic kidney disease: evidence from passive leg movement
Author(s) -
Katulka Elissa K.,
Hirt Alexandra E.,
Kirkman Danielle L.,
Edwards David G.,
Witman Melissa A. H.
Publication year - 2019
Publication title -
physiological reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 39
ISSN - 2051-817X
DOI - 10.14814/phy2.14075
Subject(s) - medicine , brachial artery , kidney disease , reactive hyperemia , cardiology , renal function , vascular disease , blood flow , blood pressure
Chronic kidney disease ( CKD ) is an independent risk factor for the development of cardiovascular disease and is characterized by reduced nitric oxide ( NO ) bioavailability and vascular dysfunction, typically assessed using brachial artery flow‐mediated dilation ( FMD ). It has been previously reported that passive leg movement ( PLM )‐induced hyperemia, an assessment of lower extremity vascular function, is highly dependent on NO , but has not yet been utilized to assess vascular function in patients with CKD . The purpose of this study was to comprehensively assess vascular function in patients with CKD using PLM , in addition to the traditional FMD technique. Assessment of vascular function via PLM and FMD was performed on 12 patients ( CKD , 66 ± 3 years) and 16 age‐matched healthy controls ( CON , 60 ± 2 years). Blood velocity and artery diameters during PLM and FMD were measured using duplex ultrasound of the femoral and brachial arteries, respectively. Habitual physical activity, assessed by accelerometry, was performed in a subset of each group. CKD patients had reduced peak leg blood flow ( LBF ) (384 ± 39 vs. 569 ± 77 mL /min, P < 0.05) and change in LBF from baseline to peak (∆peak LBF ) (143 ± 22 vs. 249 ± 34 mL /min, P < 0.05) during PLM compared to CON . Additionally, PLM responses were significantly associated with kidney function and physical activity levels. As anticipated, FMD was significantly attenuated in CKD patients (5.2 ± 1.1 vs. 8.8 ± 1.2%, P < 0.05). In conclusion, both upper and lower extremity measures of vascular function indicate impairment in CKD patients when compared to controls. PLM appears to be a novel and feasible approach to assessing lower extremity vascular function in CKD.