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International Journal of Nephrology
Volume 2011, Article ID 407801, 7 pages
http://dx.doi.org/10.4061/2011/407801
Review Article

Central Blood Pressure and Chronic Kidney Disease Progression

Renal, Electrolyte and Hypertension Division, University of Pennsylvania, 1 Founders Building, 3400 Spruce Street, Philadelphia, PA 19104, USA

Received 8 December 2010; Accepted 5 January 2011

Academic Editor: Hiromichi Suzuki

Copyright © 2011 Debbie L. Cohen and Raymond R. Townsend. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hypertension, diabetes, and proteinuria are well-recognized risk factors for progressive kidney function loss. However, despite excellent antihypertensive and antidiabetic drug therapies, which also often lower urinary protein excretion, there remains a significant reservoir of patients with chronic kidney disease who are at high risk for progression to end-stage kidney disease. This has led to the search for less traditional cardiovascular risk factors that will help stratify patients at risk for more rapid kidney disease progression. Among these are noninvasive estimates of vascular structure and function. Arterial stiffness, manifested by the pulse wave velocity in the aorta, has been established in a number of studies as a significant risk factor for kidney disease progression and cardiovascular endpoints. Much less well studied in chronic kidney disease are measures of central arterial pressures. In this paper we cover the physiology behind the generation of the central pulse wave contour and the studies available using these approaches and conclude with some speculations on the rationale for why measurements of central pressure may be informative for the study of chronic kidney disease progression.