Arterial stiffness and incident chronic kidney disease risk: a two-phase retrospective cohort study

Q: What are the key findings of this study?

Elevated arterial stiffness (baPWV ≥1,800 cm/s) was associated with a 65% greater risk of incident chronic kidney disease compared to normal arterial stiffness.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic Kidney Disease (n=83354). Intervention: Elevated arterial stiffness (baPWV ≥1,800 cm/s) vs. Normal arterial stiffness (baPWV <1,400 cm/s). Primary outcome: Incident chronic kidney disease (HR 1.65, p=<0.05).

Q: What question did this study set out to answer?

To examine the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and cardiovascular-metabolic comorbidities in predicting the development of chronic kidney disease.

Guang Yang; Xin Shen; Ying Ding; Bokai Cheng; Yansong Zheng; J. Zhao

doi:10.1186/s12882-026-04962-6

April 4, 2026BMC NephrologyOpen Access

Arterial stiffness and incident chronic kidney disease risk: a two-phase retrospective cohort study

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Key result

Elevated arterial stiffness linked to ~65% greater incident CKD risk versus normal stiffness.

HR 1.65
P<0.05
n=83,354

Figures

Why the study?

The effect of arterial stiffness on incident chronic kidney disease in healthy individuals remains unclear.

Does elevated arterial stiffness, measured by brachial-ankle pulse wave velocity, increase the risk of incident chronic kidney disease in individuals undergoing routine health examinations?

Key Points

To examine the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and cardiovascular-metabolic comorbidities in predicting the development of chronic kidney disease.
Conducted a two-phase retrospective cohort study using data from the Chinese People’s Liberation Army General Hospital (2009–2021).
Enrolled 83,354 participants in the cross-sectional phase (77,711 without CKD and 5,643 with CKD) and followed 13,738 participants longitudinally over a mean of 2.95 ± 2.02 years.
Evaluated associations between brachial-ankle pulse wave velocity and incident CKD using Cox proportional hazards regression with restricted cubic splines, stratification, and mediation analyses.
In the cross-sectional phase, mean baPWV was significantly higher in individuals with CKD (1,575.97 ± 255.42 cm/s) than in those without CKD (1,439.26 ± 214.82 cm/s, p < 0.001), with baPWV ≥ 1,800 cm/s conferring markedly increased odds of CKD compared to < 1,400 cm/s.
Over longitudinal follow-up, 403 incident CKD cases (2.93%) developed, displaying a dose–response relationship with baPWV (p < 0.001) where the highest baPWV category conferred a 65% greater risk (p < 0.05).
Mediation analysis demonstrated significant indirect effects through systolic blood pressure (52.9%), diastolic blood pressure (45.1%), hyperlipidaemia (27.5%), and glycated haemoglobin (15.3%) (all p < 0.05).

Study Design

Type

Cohort (n=83,354)

Multicenter

No

Structured PICO

Does elevated arterial stiffness, measured by brachial-ankle pulse wave velocity, increase the risk of incident chronic kidney disease in individuals undergoing routine health examinations?

P

Population

83,354 individuals attending routine health examinations at the Chinese People's Liberation Army General Hospital (2009–2021). The cross-sectional phase included 77,711 without CKD and 5,643 with CKD; the longitudinal phase included 13,738 participants.

I

Intervention

Elevated arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV), categorized as moderately elevated (1,400 ≤ baPWV < 1,800 cm/s) or severely elevated (baPWV ≥ 1,800 cm/s)

C

Comparator

Normal arterial stiffness (baPWV < 1,400 cm/s)

O

Outcome

Incident chronic kidney disease (CKD), defined as the initial documented CKD diagnosis requiring either the presence of albuminuria (UACR > 30 mg/g) or an eGFR < 60 mL/min/1.73 m²surrogate

Main Result

Effect estimate: HR 1.65

p-value: p=<0.05

Implication

Elevated arterial stiffness is significantly associated with an increased risk of incident chronic kidney disease, a relationship that is potentially mediated by blood pressure and glucose-lipid metabolism dysfunction.

Abstract

The effect of arterial stiffness (AS) on incident chronic kidney disease (CKD) in healthy individuals remains unclear. In this study, we examined the relationship between AS, measured using brachial-ankle pulse wave velocity (baPWV), and cardiovascular-metabolic comorbidities in predicting CKD development. This two-phase retrospective cohort study used data from the Chinese People’s Liberation Army General Hospital (2009–2021). The cross-sectional phase included 83,354 participants (77,711 without CKD and 5,643 with CKD), whereas the longitudinal phase included 13,738 participants. The association between baPWV and incident CKD was assessed using Cox regression analysis with restricted cubic splines, stratification, and mediation. CKD exhibited a prevalence of 6.77%. Participants with CKD had significantly higher baPWV than those without CKD. Compared to the reference category (< 1,400 cm/s), participants with baPWV ≥ 1,800 cm/s showed markedly increased odds of CKD development. Longitudinal analysis identified 403 incident CKD cases (2.93%) over a mean follow-up of 2.95 ± 2.02 years. A dose–response relationship was observed between baPWV and CKD development (p < 0.001), with the highest baPWV category conferring a 65% greater risk (p < 0.05). Mediation analysis showed significant indirect effects through systolic blood pressure (52.9%), diastolic blood pressure (45.1%), hyperlipidaemia (27.5%), and glycated haemoglobin (15.3%) (all p < 0.05). Elevated baPWV values are associated with greater incident CKD risk, with blood pressure and glucose-lipid metabolism dysfunction potentially mediating this association. Further research is needed to determine whether interventions targeting AS and metabolic parameters reduce CKD incidence.

Discussion

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Cite This Study

Yang et al. (2026) conducted a cohort in Chronic Kidney Disease (n=83,354). Elevated arterial stiffness (baPWV ≥1,800 cm/s) vs. Normal arterial stiffness (baPWV <1,400 cm/s) was evaluated on Incident chronic kidney disease (HR 1.65, p=<0.05). Elevated arterial stiffness (baPWV ≥1,800 cm/s) was associated with a 65% greater risk of incident chronic kidney disease compared to normal arterial stiffness.

synapsesocial.com/papers/69d34e1e9c07852e0af97b72 https://doi.org/10.1186/s12882-026-04962-6

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Arterial stiffness and incident chronic kidney disease risk: a two-phase retrospective cohort study

Figures

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

Arterial stiffness and incident chronic kidney disease risk: a two-phase retrospective cohort study

Figures

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

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