Are There Any Association Between Diastolic Area Index Measured by Arteriograph, Renal Function and N-Terminal Prohormone of Brain Natriuretic Peptide in Chronic Kidney Disease?

Objective: IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. Arterial stiffness may predict cardiovascular (CV) mortality and morbidity in chronic kidney disease (CKD). Diastolic area index (DAI) shows the diastolic cycle interval and may deduce to the coronary perfusion. There is limited data in the literature about the association between the DAI, the renal function and N-terminal prohormone of brain natriuretic peptide (NT-proBNP). Design and method: In our cross-sectional study, we examined 89 patients who cared for IgAN in our clinic. Arterial stiffness was determined by measuring pulse wave velocity of the aorta (PWVao) and aortic systolic pressure (SBPao) and DAI was calculated using the Arteriograph. NT-proBNP was measured using ELISA kits. Renal function was detected by the estimated glomerular filtration rate (eGFR-CKD-EPI). Furthermore, a routine echocardiography examination was performed. Results: Of the 89 patients included in the study, 50 were male, with a mean age of 54.9 ± 14.4 years. Patients were divided into five groups based on eGFR (CKD 1,2,3,4 and 5). There were significantly higher NT-proBNP (p=0.022, p=0.001) and lower DAI (p=0.007 and p=0.003) in CKD 4 and 5 compared to CKD 1 group. The PWV (p <0.001, p=0.022), and central aortic systolic pressure (p = 0.043, p=0.085), showed significant elevation with the worsening renal function. DAI showed a negative correlation with NT-proBNP (corr. coeff:-0,282, p=0.012), and a postivie correlation with eGFR (corr. coeff.: 0.331, p=0.003). SBPao and PWVao showed negative correlations with DAI (corr. coeff:-0,307, p=0.029 and -0,366, p=0.001) by Spearman's correlation. Only eGFR was an independent predictor of DAI and NT-proBNP by linear regression analysis. Conclusions: Decreasing DAI could be a possible mechanism for the development of abnormal myocardial remodelling in CKD patients, in which may help the elevation of the central aortic systolic pressure causing increased PWV and more CV complications in CKD.