Cardiovascular (CV) diseases are the most frequent cause of death in patients with end-stage-renal-
disease (ESRD). Increased arteries stiffness (AS) was found to be independent risk factor. In general
population AS is determined by age and blood pressure (BP). In patients with chronic renal disease
(CKD) it is influenced additionaly with derangements in phosphate and calcium homeostasis. Endemic
(Balkan) nephropathy (EN) is a chronic tubulointerstitial nephropathy characterized by normal BP values
in early stages of CKD and hypertension (HT) appears in advanced CKD stages. Obviously, BP in EN has
less impact on AS than in other CKD. The aim of this study was to analyze whether AS is lower in EN
patients compared to patients with other ESRD undergoing chronic hemodialysis. In this study, 186
patients were included (90 EN, 96 non-EN) from three dialysis centers in Croatia and Bosnia and
Herzegovina. After 25 months, control measurements were taken on 97 survived patients still treated with
chronic hemodialysis. The obtained results confirmed the hypothesis that AS is lower in patients with EN.
Prevalence of hypertension was lower in EN patients and they required less antihypertensives. Patients
with EN had significantly lower serum phosphate levels, calcium x phosphate, and parathormone. All
these factors were predictors of AS, but in three models of linear regression EN was the strongest negative
predictor for AS. In logistic regression the ratio of AS was statistically significantly higher in patients
without EN. The patients with EN were significantly older when they started their dialysis treatment,
which indicates the slower progression of CKD. These patients had significantly lower CV mortality after
25 months of follow-up. Endemic nephropathy is an independent predictor of lower AS values. AS
develops slower due to later onset of HT in predialytic course, lower BP values and milder HT and better
control during dialysis treatment. In addition, they had better control of calcium and phosphates, which
consequently causes slower progression of kidney disease and lower CV mortality
