The relationships among the cardio-ankle vascular index values, proteinuria, and eGFR in diabetic and non-diabetic patients (the Coupling Registry)

Introduction: Chronic kidney disease (CKD) raises cardiovascular risk, but its link with the cardio ankle vascular index (CAVI) in diabetic and non diabetic patients remains unclear. The aim of this study was to clarify the relationships between CAVI values and an aspect of renal function. Results: The proteinuria positivity rate differed significantly between the low- and high-CAVI groups, and the difference was significant even after adjusting for age, gender, and other factors. Although direct comparisons showed a higher proportion of CKD (eGFR < 60 mL/min/1.73 m²) in the high CAVI group, this difference disappeared after adjustment. We further divided the low- and high-CAVI groups into diabetes mellitus (DM) and no diabetes mellitus (non-DM) subgroups to examine the rate of proteinuria positivity and the percentage of patients with eGFRs <60 mL/min/1.73 m2. After the multivariate analysis adjustment, the odds ratios (ORs) for positive proteinuria the high-CAVI group were 1.58 (confidence interval CI: 1.07–2.34, p=0.022) for the non-DM subgroup and 0.88 (95%CI: 0.57–1.38, p=0.587) for the DM subgroup. The percentage of patients with eGFRs <60 mL/min/1.73 m2 was not significantly different between the low- and high-CAVI groups in both the DM and non-DM subgroups after the multivariate analysis adjustment (p=0.088 for non-DM and p=0.135 for DM). Conclusions: Proteinuria was associated with a CAVI ≥8 in patients without diabetes mellitus. High arterial stiffness may serve as a surrogate marker for renal damage in non diabetic patients.