P4.06 ARTERIAL STIFFNESS CORRELATES WITH VITAMIN D DEFICIENCY IN HYPERTENSIVE PATIENTS WITH STAGE 3 CHRONIC KIDNEY DISEASE INDEPENDENTLY OF BLOOD PRESSURE

Abstract

Objectives: To assess the prevalence of vitamin D deficiency and hyperparathyroidism as well as their relationship to blood pressure and arterial stiffness in hypertensive patients with stage 3 chronic kidney disease (CKD). Methods: Cross-sectional study that included 134 treated hypertensives (76 women, 56,7%) with stage 3 CKD (eGFR 49,2 ml/min, SD±8) without previous vitamin D supplementation treatment. Standard clinical care was performed including ECG, microalbuminuria and usual laboratory parameters. Arterial stiffness was measured by brachial oscillometry with the validated Mobil-O-Graph® device. Normal values for vitamin D and PTH were set as 30 ng/ml and 65 pg/ml, respectively. Results: The mean age was 73,0 years (SD±10) with office BP of 131/75 mmHg (SD±17/11). The prevalence of vitamin D deficiency was 89% (mean: 19 ng/ml (SD±10)), secondary hyperparathytoidism was observed in 49% of patients (mean: 70,5 pg/ml (SD±10)), 84 (62,7%) patients had a pulse wave velocity (PWV) over 10 m/sec (mean 10,7 m/sec, (SD±1,8). In bivariate analysis PWV correlated best with age (r=930;p<0.0001), followed by SBP (r=345;p<0.0001), vitamin D (r=310;p<0.0001), PTH, calcium, fosforous and ventricular mass (CORNELL). In multiple lineal regression analysis, only age, SBP and vitamin D remained significantly associated with arterial stiffness. In logistic regression with presence /absence of PWV ≥ 10 m/sec as dependent variable, male gender, age, elevated SBP and vitamin D categorized in tertiles were significantly related to increased PWV. Conclusions: In hypertensive patients with stage 3 CKD vitamin D deficiency is associated to increased PWV independently of blood pressure, gender and age.