Arterial stiffness parameters derived by oscillometric pulse wave analysis are related to estimated glomerular filtration rate but not proteinuria in Gujarati diabetics

Introduction: Diabetes mellitus (DM) imposes significant cardiovascular risk beyond raised blood pressure. Pulse wave analysis (PWA) infers directly about the same by arterial stiffness (AS) assessment. We studied the relation between AS and diabetic nephropathy (DN) in type 2 diabetics (T2D). Materials and Methods: We evaluated 164 T2Ds in a cross-sectional study. Oscillometric PWA performed by Mobil-o-Graph (IEM, Germany) reported AS parameters such as augmentation pressure (AP), augmentation index at heart rate 72, reflection magnitude, and aortic pulse wave velocity (aPWV). DN was evaluated by creatinine, proteinuria, and estimated glomerular filtration rate (eGFR). Parameters were further analyzed for the effect of gender, proteinuria, and grades of DN by eGFR. Multiple linear regressions were used to find significant predictors. P <0.05 was taken as statistical significance. Results: Case group constituted 91 males, with mean age 56 years, with mean duration 4.48 years, 70% prevalence of hypertension and poor glycemic control. There was mild to moderate DN and 34% prevalence of proteinuria. AS parameters were not affected significantly by proteinuria, but by increasing grades of DN. aPWV and AP were predictors of eGFR, whereas AP was a predictor of creatinine. Conclusions: AS was related with estimated GFR but not with proteinuria in Gujarati diabetics with high co-existing hypertension and predominantly mild-to-moderate grade nephropathy.