Arterial Stiffness and Decline in Kidney Function

Abstract

Background and objectives The independent link between arterial stiffness and CKD remains unknown. We investigated the association of indicators of arterial stiffness with decline in kidney function.Design, setting, participants, & measurements We studied 3666 participants (mean age =65 years old; 58% women) from the Rotterdam Study. Pulse pressure (PP), carotid stiffness, and pulse wave velocity (PWV) were measured. We created genetic risk scores for PP and PWV. Annual declines in kidney function and incident CKD were assessed using eGFR. To put our findings in context of the literature, we performed a meta-analysis of the available population-based studies.Results After a median (interquartile range) follow-up time of 11 (10.7-11.3) years, 601 participants with incident CKD were recognized. In the model adjusted for age, sex, mean arterial pressure, heart rate, and baseline GFR, each SD higher PP was associated with 0.15-ml/min per 1.73 m 2 steeper annual eGFR decline (95% confidence interval [95% CI], 0.10 to 0.20) and 11% higher risk of incident CKD (95% CI, 1.05 to 1.18). Each SD greater carotid stiffness was associated with 0.08-ml/min per 1.73 m 2 steeper annual eGFR decline (95% CI, 0.04 to 0.13) and 13% higher risk of incident CKD (95% CI, 1.05 to 1.22). Each SD higher PWV was associated with 7% higher risk of incident CKD (95% CI, 1.00 to 1.14). Incorporating our findings in a meta-analysis, each SD higher PP and PWV were associated with 16% (95% CI, 1.12 to 1.21) and 8% (95% CI, 1.03 to 1.14) higher risks of incident CKD. Each SD higher PP genetic risk score was associated with 0.06-ml/min per 1.73 m 2 steeper annual eGFR decline (95% CI, 0.01 to 0.10) and 8% higher risk of incident CKD (95% CI, 1.03 to 1.14). There was no association between PWV genetic risk score and kidney function decline.Conclusions Higher indices of arterial stiffness are associated with steeper decline in kidney function. This suggests that vascular stiffness could be considered as a target for delaying decline in kidney function.

High Ambulatory Arterial Stiffness Index Is an Independent Risk Factor for Rapid Age-Related Glomerular Filtration Rate Decline in the General Middle-Aged Population

“…The mean baseline age of our cohort was younger than in other studies of the effect of arterial stiffness on GFR decline. 6,8,26 This finding suggested that arterial stiffness might be an early stage in the mechanism for accelerated GFR decline. We previously reported that baseline conventional BP per se did not accelerate age-related GFR decline in the RENIS cohort, 19 and the current investigation found the same results for ABP (Table 3).…”

“…Three previous longitudinal, population-based studies of estimated GFR decline used carotid femoral pulse wave velocity (PWV). 6,8,26 Although none of them found an effect on the GFR decline rate as a continuous variable, increased PWV was associated with an increased odds ratios for rapid GFR decline in the AGES Reykjavik study and for incident chronic kidney disease stage 3 in the Health ABC study (Health, Aging, and Body Composition). 6,8 In contrast, there was no effect of PWV on incident chronic kidney disease stage 3 in the Framingham Offspring Study.…”

Characteristics of the Chronic Heart Failure Course and Target Organ Condition in Cardiorenal Syndrome

“…Нами получены данные о вза-имном негативном влиянии нарушений фильтраци-онной функции на артериальное ремоделирование при ХСН и ХБП. Вклад артериальной жесткости в развитие ХБП показан в исследовании Sedaghat S, et al [9]. В Rotterdam Study было найдено, что увеличе-ние жесткости в сонных артериях на 1 стандартное отклонение ассоциируется с увеличением риска раз-вития ХБП на 13% (95% ДИ, 1,05-1,22).…”

Higher Plasma Transforming Growth Factor (Tgf)-B Is Associated With Kidney Disease in Older Community-Dwelling Adults

“…The high prevalence of CKD in older adults is attributable not only to the presence of traditional risk factors such as diabetes and hypertension but may also be the result of age-related functional changes that occur in the kidney [20]. Importantly, epidemiological studies have identified arterial stiffness (which increases with age) as a predominant risk factor for progressive GFR decline in older people [21,22]. We have previously shown TGF-β levels independently predict peripheral vascular disease in aged community-dwelling adults [23].…”