Central blood pressure in chronic kidney disease: latest evidence and clinical relevance.

Chronic kidney disease (CKD) has been consistently associated with cardiovascular disease; there is an inverse graded relationship between glomerular filtration rate and cardiovascular risk. Early-moderate CKD receives increasing recognition for its role as an independent risk factor as evidenced by its recent inclusion in the Joint British Societies' consensus recommendations for the prevention of cardiovascular disease. Data from both imaging and epidemiological studies suggest arterial stiffening and structural left ventricular disease (hypertrophy and fibrosis) are the key pathogenic mediators of cardiovascular disease in CKD. This review discusses the rationale for measuring central blood pressure in patients with CKD and whether it could provide incremental prognostic value beyond that of peripheral blood pressure.