Key result
Higher central arterial stiffness, indicated by carotid-femoral pulse wave velocity in the highest quartile, was associated with an increased risk of acute kidney injury compared to the second quartile.
Why the study?
Prediction of incident AKI is inaccurate, and additional predictors are needed; arterial stiffness may serve as a plausible predictor.
Does higher arterial stiffness, measured by carotid-femoral pulse wave velocity, predict incident acute kidney injury in community-dwelling older adults?
Cohort (n=4,245)
Yes
Does higher arterial stiffness, measured by carotid-femoral pulse wave velocity, predict incident acute kidney injury in community-dwelling older adults?
Higher central arterial stiffness, measured by carotid-femoral pulse wave velocity, is independently associated with an increased risk of acute kidney injury in community-dwelling older adults.
Answers are grounded in this paper and cite their sources.
Should not yet change AKI risk assessment in older adults; leaves open whether reducing arterial stiffness prevents AKI.
Rationale & Objective: Acute kidney injury (AKI) is associated with prolonged hospitalization and increased in-hospital mortality risk. However, the prediction of incident AKI is inaccurate, and additional predictors of AKI are strongly needed. Arterial stiffness, as measured using carotid-femoral pulse wave velocity (cfPWV), is associated with kidney function decline and may serve as a plausible predictor of AKI. We hypothesized a higher cfPWV at baseline would be independently associated with AKI risk in community-dwelling older adults who participated in the Atherosclerosis Risk in Communities study. Study Design: Observational cohort study. Setting & Participants: Community-dwelling older adults from the Atherosclerosis Risk in Communities study. Predictors: The primary predictor was cfPWV and secondary predictors were heart-femoral pulse wave velocity (PWV), heart-carotid PWV, heart-ankle PWV, and brachial-ankle PWV, and femoral-ankle PWV. Outcomes: Time to AKI, defined by International Classification of Diseases (ICD) codes. Analytical Approach: Cox proportional hazard models were used to examine the association between PWV measures and time to AKI. Given its J-shaped relation with AKI, PWV was modeled as a categorical variable in quartiles (Q), with Q2 serving as the reference category. Results: A total of 4,245 participants (44% male; 77% White; mean ± SD age 75 ± 5 years; cfPWV 11.9 ± 3.9 m/s) were included. There was a J-shaped association between cfPWV and AKI risk (Q1, hazard ratio 1.15 [95% confidence interval 0.90-1.46]; Q4, 1.38 [1.08-1.77] vs Q2 reference) after fully adjusting for demographics, cardiovascular disease risk factors, and markers for kidney function and peripheral artery disease. Limitations: Most of the participants were White; and AKI was defined based on ICD codes. Conclusions: Higher arterial stiffness, measured by cfPWV, may potentially serve as a predictor of AKI risk in community-dwelling older adults.
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Oh et al. (2025) conducted a cohort in Acute kidney injury (n=4,245). Carotid-femoral pulse wave velocity (cfPWV) vs. Quartile 2 of cfPWV was evaluated on Time to acute kidney injury (AKI) (HR 1.38, 95% CI 1.08-1.77). Higher central arterial stiffness, indicated by carotid-femoral pulse wave velocity in the highest quartile, was associated with an increased risk of acute kidney injury compared to the second quartile.
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