CLINICAL NEPHROLOGY: Edited by Bradley M. DenkerArterial stiffness in chronic kidney disease an updateTaal, Maarten W.Author Information Department of Renal Medicine, Royal Derby Hospital, Derby, UK Correspondence to Maarten W. Taal, Department of Renal Medicine, Royal Derby Hospital, Uttoxeter Road, Derby, Derbyshire, DE22 3NE, UK. Tel: +44 1332 789344; fax: +44 1332 789352; e-mail: [email protected] Current Opinion in Nephrology and Hypertension: March 2014 - Volume 23 - Issue 2 - p 169-173 doi: 10.1097/01.mnh.0000441153.40072.e0 Buy Metrics Abstract Purpose of review Epidemiological studies have established arterial stiffness as an important risk factor for cardiovascular events and mortality in people with chronic kidney disease (CKD) at all stages. Although much has been learned about the mechanisms that lead to arterial stiffening in CKD, many questions remain unanswered and the optimal interventions for attenuating arterial stiffness remain to be determined. Recent findings Recent data have confirmed the value of arterial stiffness as a predictor of both cardiovascular and renal risk. Advanced glycation end-product accumulation and chronic cytomegalovirus infection have been identified as novel potential contributors to arterial stiffening, but fibroblast growth factor 23 has not. Genetic studies suggest that the association between chronic kidney and cardiovascular disease is a result of clinical and environmental rather than genetic factors. Treatment with angiotensin-converting enzyme inhibitor or aldosterone inhibitor improves arterial stiffness in association with lowering blood pressure, but several potential novel interventions for reducing arterial stiffness await further investigation. Summary Arterial stiffness is increasingly recognized as an important potentially modifiable measure of subclinical vascular disease in people with CKD. The introduction of arterial stiffness into routine practice awaits research focussed on including pulse wave velocity in renal and cardiovascular risk prediction tools, as well as interventions for ameliorating arterial stiffness. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.