Key result
Higher arterial stiffness, evaluated by the highest quartile of carotid-femoral pulse wave velocity, was independently associated with an increased risk of developing proteinuria (OR 1.93; 95% CI 1.15 to 3.25).
Why the study?
Does increased arterial stiffness evaluated by cfPWV increase the risk of developing CKD in adults without baseline CKD?
Cohort (n=7,154)
Does increased arterial stiffness evaluated by cfPWV increase the risk of developing CKD in adults without baseline CKD?
Effect estimate: OR 1.93 (95% CI 1.15 to 3.25)
Increased arterial stiffness, measured by cfPWV, is independently associated with a higher risk of developing proteinuria in adults without baseline CKD.
Arterial stiffness may flag higher proteinuria risk without baseline CKD; hypothesis-generating and requires prospective validation before clinical adoption.
Aim Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Although pulse wave velocity (PWV), which reflects arterial stiffness, was increased in subjects with CKD, little is known regarding whether arterial stiffness can increase the risk of CKD. To help clarify this we conducted a prospective cohort study to measure the association of arterial stiffness with CKD. Methods A total of 7154 adults aged 54.8 ± 10.6 years undergoing physical examinations without CKD at baseline were enrolled. Arterial stiffness was evaluated by carotid‐femoral pulse wave velocity (cfPWV). CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min per 1.73 m 2 ) or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method. Results During 3 years of follow‐up, 167 (2.3%) patients developed CKD, 101 (1.4%) patients with proteinuria and 68 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, either cfPWV (per 1 m/s increase) or the highest quartile of cfPWV (increased cfPWV) was independently associated with increased risk of proteinuria, with a fully adjusted OR of 1.15 (95% CI, 1.07 to 1.23) and 1.93 (95% CI, 1.15 to 3.25), respectively. By contrast, neither cfPWV (per 1 m/s increase) nor increased cfPWV was associated with decreased eGFR in the multivariable logistic regression analysis. Conclusions The study revealed that arterial stiffness increases the risk of proteinuria. This suggests that vascular stiffness could be considered as a target for delaying the development of CKD.
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Kong et al. (2016) conducted a cohort in Chronic kidney disease (n=7,154). Carotid-femoral pulse wave velocity (cfPWV) vs. Lower cfPWV was evaluated on Development of CKD (decreased eGFR < 60 mL/min per 1.73 m2 or presence of proteinuria) (OR 1.93, 95% CI 1.15 to 3.25). Higher arterial stiffness, evaluated by the highest quartile of carotid-femoral pulse wave velocity, was independently associated with an increased risk of developing proteinuria (OR 1.93; 95% CI 1.15 to 3.25).
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