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December 28, 2012Clinical Journal of the American Society of NephrologyOpen Access

Association of Arterial Rigidity with Incident Kidney Disease and Kidney Function Decline

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Why the study?

Does increased arterial rigidity (assessed by aPWV and PP) associate with rapid kidney function decline and incident CKD in older adults?

Population

2,129 older adults with a baseline measurement of aortic pulse wave velocity, pulse pressure, and cystatin…

Design

Cohort

Follow-up

median 8.9 years

Authors

MMMagdalena MaderoTufts UniversityCPCarmen A. PeraltaUniversity of Southern CaliforniaRKRonit KatzUniversity of Vermont

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Implication

Arterial stiffness markers may flag higher CKD risk in older adults; extends observational links but leaves open causal role and need for trials.

Key Points

  • This study aims to assess the relationship between arterial rigidity indicators and kidney function decline in older adults.
  • Evaluated 2129 older adults using baseline measurements of aortic pulse wave velocity (aPWV), pulse pressure (PP), and cystatin C.
  • Monitored kidney function decline through estimated GFR cysC across follow-up periods of 3 and 10 years.
  • Employed multivariate regression models to analyze associations between aPWV, PP, and kidney outcomes.
  • aPWV showed no significant association with rapid kidney function decline (OR 1.16, 95% CI 0.89–1.52).
  • aPWV was linked to increased risk of incident CKD (IRR 1.39, 95% CI 1.09–1.77).
  • PP was related to rapid kidney function decline (OR 1.10, 95% CI 1.04–1.16) and also elevated risk of incident CKD (IRR 1.06, 95% CI 1.01–1.11).

Structured PICO

Does increased arterial rigidity (assessed by aPWV and PP) associate with rapid kidney function decline and incident CKD in older adults?

P
Population
2,129 older adults with a baseline measurement of aortic pulse wave velocity (aPWV), pulse pressure (PP), and cystatin C, and at least one additional measurement of cystatin C at year 3 or year 10.
I
Intervention
Aortic pulse wave velocity (aPWV) and pulse pressure (PP) as measures of arterial rigidity
O
Outcome
Rapid kidney function decline (estimated GFR cysC loss of >3 ml/min per 1.73 m2 per year) and incident CKD (eGFR cysC < 60 ml/min per 1.73 m2 in participants with baseline estimated GFR > 60 ml/min per 1.73 m2)surrogate

Large arterial stiffness and pulsatility are associated with incident chronic kidney disease in older adults, highlighting a potential vascular target to prevent kidney function decline.

Cite This Study

Madero et al. (2012) studied this question.

synapsesocial.com/papers/69d572ee75589c71d767e92ehttps://doi.org/10.2215/cjn.07900812
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pulse pressure and progression of chronic kidney disease2010 · 40 citations
  2. 2Relationship Between Aortic Stiffening and Microvascular Disease in Brain and Kidney2005 · 1,286 citations
  3. 3Mortality Risk Stratification in Chronic Kidney Disease2006 · 344 citations
  4. 4Markers of Arterial Stiffness Are Risk Factors for Progression to End-Stage Renal Disease among Patients with Chronic Kidney Disease Stages 4 and 52007 · 90 citations
  5. 5Arterial Stiffness in Mild-to-Moderate CKD2009 · 159 citations