PACK: Progression of Arterial and Cardiac disease in Kidney patients
Research type
Research Study
Full title
A prospective study on progression of cardiovascular disease in chronic kidney disease patients and controls
IRAS ID
155398
Contact name
Avijit Banerjee
Contact email
Sponsor organisation
St George's Healthcare NHS Trust
Research summary
Chronic kidney disease (CKD) involves 10-15% of the general population and the patients with CKD suffer from excess heart attacks and strokes (cardiovascular disease). These events are a common cause of death in CKD patients, which often is sudden. The exact nature of cardiovascular disease is unknown.
We have previously demonstrated highly abnormal reactivity (endothelial dysfunction) and thickening, stiffening and furring (atherosclerosis) of the blood vessels in predialysis, dialysis and post kidney transplant patients. We have also demonstrated thickening (intimal hyperplasia) of blood vessels on histology. However no study has examined the natural progression of these changes in structure and reactivity of blood vessels in CKD patients, which this study will do.
Endothelial dysfunction is common and a precursor of atherosclerosis. Inflammation causes endothelial dysfunction and may lead to atherosclerosis.
We have recently demonstrated that autonomic regulation and electrical activation of the heart assessed by surface electrocardiogram may be useful to predict cardiac risk in dialysis patients. However no study has examined the natural progression of electrical activation of the heart in CKD patients, which this study will do.
The rate and the pattern of progression of the blood vessel and heart disease in CKD patients is unknown. If known it will help identify the patients at higher risk, who progress rapidly. Identifying these patients will help manage care.
The proposed clinical study will examine with non-invasive ultrasound examinations and blood pressure measurements the changes after 3-6 months and 1 year in brachial artery flow mediated dilation, carotid and brachial intima-media thickness, carotid-femoral pulse wave velocity and augmentation index, ankle-brachial index, which are indicative of blood vessels structure and reactivity. Furthermore this study will examine heart rate variability and repolarisation irregularities, which are markers of electrical activation of the heart, and blood biomarkers of endothelial function and inflammation.REC name
London - South East Research Ethics Committee
REC reference
14/LO/0797
Date of REC Opinion
23 Jun 2014
REC opinion
Further Information Favourable Opinion