The correlation between serum endothelin-1 levels and aortic stiffness in patients with non-dialysis chronic kidney disease

Increased aortic stiffness (AS) is a recognized predictor of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD), and endothelin-1 (ET-1), a potent vasoconstrictor, has been associated with vascular dysfunction and atherosclerosis. This study examined the relationship between serum ET-1 levels and AS in patients with non-dialysis CKD. A total of 232 adults with CKD stages 3-5 were enrolled. Fasting blood samples were obtained to measure serum ET-1 concentrations using an enzyme immunoassay, and AS was assessed by carotid-femoral pulse wave velocity (cfPWV) measured using cuff-based volumetric displacement, with cfPWV >10 m/s defining AS. Among the participants, 75 patients (32.3%) were classified as having AS. Compared with those without AS, patients with AS were older and had higher prevalences of diabetes mellitus and hypertension, as well as significantly higher serum ET-1 levels, blood pressure, fasting glucose, HbA1c, and urine protein-to-creatinine ratio. Serum ET-1 levels were positively correlated with cfPWV and remained independently associated with cfPWV in multivariable linear regression analysis. Furthermore, multivariable logistic regression identified serum ET-1, age, diastolic blood pressure, and diabetes mellitus as independent factors associated with AS, with consistent results observed in bootstrap analyses. These findings demonstrate an independent association between serum ET-1 levels and increased cfPWV and AS in patients with non-dialysis CKD.