Mineral metabolism influences pulse pressure increase provoked by chronic kidney disease.

Background: Pulse pressure (PP) increase has been associated with hypertension, ageing and chronic kidney disease. Although hyperparathyroidism and phosphate imbalance have been suspect in PP increase in hemodialysis patients, the link between these parameters and pulse pressure, in renal disease before dialysis, has not been established. Methods and patients: 1966 chronic kidney disease (CKD) patients. Statistics: ANOVA, Student's t-and Chi-square, rank correlations (Spearman) and multivariate analysis, with PP as the dependent variable, while adjusting for other covariables. Results: There was an increase of pulse pressure parallel to renal function deterioration, and a significant influence of age, diabetes, hypertension, phosphate and PTH on pulse pressure in the whole population, as well as in patients with glomerular filtration rate < 60 ml/min. The impact of phosphate was particularly high after the age of 50. Conclusion: PP increase present in renal disease patients might be primarily due to the underlying mineral metabolism disturbances.