Abstract P310: Arterial Stiffness and Chronic Kidney Disease
Arterial stiffness is an independent risk factor for cardiovascular disease in select groups, including those with end-stage renal disease. However, the limited research into the role of arterial stiffness in predialysis chronic kidney disease (CKD) has produced inconsistent results. In this study we investigated the association of arterial stiffness, measured by central pulse pressure (CPP) and pulse wave velocity (PWV), with CKD and CKD severity in 201 cases with CKD and 201 controls without in the greater New Orleans, Louisiana area. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 or presence of albuminuria. Mean levels of CPP and PWV by CKD status adjusted for age, gender, race, smoking, alcohol use, education, physical activity, low-density lipoprotein cholesterol, glucose, body mass index, and history of cardiovascular disease were calculated. Multivariate-adjusted regression coefficients of eGFR and urinary albumin associated with one standard deviation differences in CPP and PWV were estimated. Participants were 50.3% (202 out of 402) male, 56.0% (225 out of 402) African-American, and had a mean age of 54.2 years. Unadjusted (45.5 vs. 35.6 mmHg, p<0.0001) and adjusted (43.6 vs. 37.1 mmHg, p<0.0001) mean levels of CPP were significantly higher in CKD cases compared to controls. PWV was associated with CKD in unadjusted analyses (11.0 vs. 8.9 m/sec, p<0.0001), but after adjustment the difference in cases and controls was attenuated (10.3 vs. 9.6 m/sec, p=0.08). A one standard deviation increase in CPP was associated with a decrease in eGFR (β = -6.5; 95% CI, -9.7, -3.2) and an increase in urinary albumin (β = 0.4; 95% CI, 0.2, 0.6), and the direction of the associations was consistent with markers of disease severity. PWV is also positively associated with urinary albumin (β = 0.3; 95% CI, 0.1, 0.5), and, while not statistically significant, shows an inverse association with eGFR (β = -2.9; 95% CI, -6.2, 0.4). Our study found that increased CPP and PWV are associated with CKD and disease severity, as measured by eGFR and urinary albumin. In conclusion, these findings suggest that arterial stiffness may play a role in the etiology of CKD. Longitudinal studies are warranted to further evaluate the temporal relationship of arterial stiffness with development of CKD.
- © 2013 by American Heart Association, Inc.