Sex differences in microvascular function and arterial hemodynamics in nondialysis chronic kidney disease

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Author(s)Kirkman, Danielle L.
Author(s)Ramick, Meghan G.
Author(s)Muth, Bryce J.
Author(s)Stock, Joseph M.
Author(s)Townsend, Raymond R.
Author(s)Edwards, David G.
Date Accessioned2022-12-20T19:03:57Z
Date Available2022-12-20T19:03:57Z
Publication Date2022-12-01
DescriptionThis article was originally published in American Journal of Physiology - Heart and Circulatory Physiology. The version of record is available at: https://doi.org/10.1152/ajpheart.00500.2022. This article will be embargoed until 12/01/2023.
AbstractCardiovascular disease (CVD) is the leading cause of death in chronic kidney disease (CKD). Abnormal arterial hemodynamics contribute to CVD, a relationship that can be mediated by microvascular dysfunction. The purpose of this study was to investigate potential sex differences in arterial hemodynamics and microvascular dysfunction in patients with stages 3 to 4 CKD. Vascular function was assessed in 22 male (mean ± SD; age, 56 ± 13 yr) and 10 female (age, 63 ± 9 yr) patients. Arterial hemodynamics were acquired with combined tonometry and oscillometry. Skin blood flow was used as a model of microvascular function. Participants were instrumented with three microdialysis fibers for the delivery of 1) Ringer’s solution; 2) superoxide dismutase mimetic, Tempol; and 3) nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor, apocynin. Blood flow was measured via laser-Doppler flowmetry during standardized local heating (42°C). Central pulse pressure (mean ± SE; 62 ± 9 vs. 46 ± 3 mmHg; P = 0.01) and augmentation index (36 ± 3 vs. 26 ± 3%; P = 0.03) were higher in females. There was a trend for higher central systolic pressures in females (146 ± 9 vs. 131 ± 3 mmHg; P = 0.06). Females reported higher forward (39 ± 4 vs. 29 ± 2 mmHg; P = 0.004) and reflected (27 ± 3 vs. 19 ± 1 mmHg; P < 0.001) wave amplitudes. Cutaneous vascular function was impaired in females compared with males (77 ± 3 vs. 89 ± 1%, P = 0.001). Microvascular function was improved following the delivery of Tempol and apocynin in females but not in males. Female patients with CKD had poorer central hemodynamics and reduced microvascular function compared with their male counterparts. Oxidative stress may contribute to lower microvascular function observed in females. NEW & NOTEWORTHY There are limited data regarding the physiological mechanisms of potential sex differences in central hemodynamics and vascular function in chronic kidney disease (CKD). We report that older female patients with nondialysis CKD have higher central pulse pressures compared with male patients with CKD. In addition, older females with CKD have lower microvascular function compared with their male counterparts, and oxidative stress contributes to the lower microvascular function in older female patients with CKD.
SponsorThis work was supported by National Institutes of Health Grants R01HL113514 and P20GM113125.
CitationKirkman, Danielle L., Meghan G. Ramick, Bryce J. Muth, Joseph M. Stock, Raymond R. Townsend, and David G. Edwards. “Sex Differences in Microvascular Function and Arterial Hemodynamics in Nondialysis Chronic Kidney Disease.” American Journal of Physiology-Heart and Circulatory Physiology 323, no. 6 (2022): H1130–36. https://doi.org/10.1152/ajpheart.00500.2022.
ISSN1522-1539
URLhttps://udspace.udel.edu/handle/19716/31834
Languageen_US
PublisherAmerican Journal of Physiology - Heart and Circulatory Physiology
Keywordsarterial hemodynamics
Keywordschronic kidney disease
Keywordsmicrovascular function
Keywordsoxidative stress
Keywordssex differences
TitleSex differences in microvascular function and arterial hemodynamics in nondialysis chronic kidney disease
TypeArticle
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