Pulse pressure, but not pulse wave velocity, was independently associated with rapid decline in kidney function in patients with early chronic kidney disease (OR 1.22; 95% CI 1.01-1.48; P=.045).
Cohort (n=913)
Are pulse wave velocity and pulse pressure associated with rapid decline in kidney function in patients with mild to moderate chronic kidney disease?
In patients with mild to moderate chronic kidney disease, pulse pressure is an independent risk factor for rapid kidney function decline, whereas pulse wave velocity is not.
Odds Ratio: 1.22 (95% CI 1.01–1.48)
p-value: p=0.045
The association between arterial stiffness and decline in kidney function in patients with mild to moderate chronic kidney disease (CKD) is not well established. This study investigated whether pulse wave velocity (PWV) and pulse pressure (PP) are independently associated with glomerular filtration rate (GFR) and rapid decline in kidney function in early CKD. Carotid femoral PWV (cfPWV), brachial-ankle PWV (baPWV), and PP were measured in a cohort of 913 patients (mean age, 63±10 years; baseline estimated GFR, 84±18 mL/min/1.73 m(2) ). Estimated GFR was measured at baseline and at follow-up. The renal outcome examined was rapid decline in kidney function (estimated GFR loss, >3 mL/min/1.73 m(2) per year). The median follow-up duration was 3.2 years. Multivariable adjusted linear regression model indicated that arterial PWV (both cfPWV and baPWV) and PP increased as estimated GFR declined, but neither was associated with kidney function after adjustment for various covariates. Multivariable logistic regression analysis found that cfPWV and baPWV were not associated with rapid decline in kidney function (odds ratio OR, 1.39, 95% confidence interval CI, 0.41-4.65; OR, 2.51, 95% CI, 0.66-9.46, respectively), but PP was (OR, 1.22, 95% CI, 1.01-1.48; P=.045). Arterial stiffness assessed using cfPWV and baPWV was not correlated with lower estimated GFR and rapid decline in kidney function after adjustment for various confounders. Thus, PP is an independent risk factor for rapid decline in kidney function in populations with relatively preserved kidney function (estimated GFR ≥30 mL/min/1.73 m(2) ).
Kim et al. (2014) conducted a cohort in mild to moderate chronic kidney disease (n=913). Pulse pressure and pulse wave velocity was evaluated on Rapid decline in kidney function (estimated GFR loss >3 mL/min/1.73 m2 per year) (OR 1.22, 95% CI 1.01-1.48, p=0.045). Pulse pressure, but not pulse wave velocity, was independently associated with rapid decline in kidney function in patients with early chronic kidney disease (OR 1.22; 95% CI 1.01-1.48; P=.045).