Arterial stiffness and decline of renal function in a primary care population

Varik, Bernard J. van; Vossen, Liv M; Rennenberg, Roger J M W; Stoffers, Jelle; Kessels, Alfons G.H.; Leeuw, Peter W. de; Kroon, Abraham A.

doi:10.1038/hr.2016.113

Cited by 28 publications

(20 citation statements)

References 36 publications

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“…This was consistent with related clinical studies, in which aortic stiffness is shown to be independently associated with progressive renal impairment among patients with advanced CKD 21 ) , and a greater PWV among patients was detected in more advanced CKD from stages 1–5 22 ) . In contrast, some studies have reported that arterial stiffness did not predict GFR decline in moderate to advanced CKD 23 ) , but arterial stiffness negatively correlated with estimated GFR in a primary care population without CKD 24 ) . The conflicting results may be explained by the difference in patients' characteristics, measurement techniques for vascular stiffness, clinical study design, and duration of follow-up.…”

Section: Discussionmentioning

confidence: 89%

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Satirapoj

Triwatana

Supasyndh

2020

JAT

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Arterial stiffness is known to be an important surrogate marker for atherosclerosis and predictor of peripheral vascular and cardiovascular (CV) disease. Whether high cardio-ankle vascular index (CAVI) is associated with the development of rapid glomerular filtration rate (GFR) decline remains uncertain. The study aimed to determine the relationship between CAVI and renal function progression among patients with high CV risk. Methods: This study employed a prospective cohort design with 1-year follow-up among patients with high CV risk. Arterial stiffness was measured using CAVI method. GFR was estimated using the chronic kidney disease (CKD) epidemiology collaboration equation, and rapid decline in GFR was defined with decrease in GFR ≥ 5 mL/min/1.73 m 2 yearly. Results: Of 352 patients with mean age 67.8 10.1 years, 224 patients (63.6%) were suspected to have arteriosclerosis (CAVI ≥ 9), and 208 patients (59.1%) had CKD (GFR 60 mL/min/1.73 m 2). Annual decline of GFR was −0.75 [interquartile range (IQR), −1.16 to 6.08] mL/min/1.73 m 2 /year, and 30.1% of patients experienced a rapid decline in GFR. Compared with normal CAVI (CAVI 8), high CAVI (CAVI ≥ 9) and borderline CAVI (CAVI 8-8.9) in all subjects and subgroup of baseline GFR 60 mL/min/1.73 m 2 were associated with rapid GFR decline. Multivariable analysis showed that high CAVI and borderline CAVI were associated with 2.47-fold (95% CI, 0.89-6.84; P 0.082) and 4.04-fold (95% CI, 1.46-11.18; P 0.007) increased odds ratio of rapid GFR decline, respectively. Conclusion: Among patients with high risk of CV with or without CKD, high CAVI (cut point of ≥ 9) was independently associated with a rapid decline in GFR, suggesting that systemic vascular stiffness predicted a decrease in renal function in this population. ness of vessels potentially leads to microvascular ischemia and tissue damage including renal microvascular supply 6). Arterial stiffening causes increased systolic blood pressure and pulse pressure. Both factors might be associated with rapid decline in glomerular filtration rate (GFR) 7). Related clinical studies have indicated an independent association between arterial stiffness and decline in renal function, but the results were inconsistent, differing in study populations, environments, and confounding factors 8-11). The association between arterial stiffness and renal progression remains to be established. Cardio-ankle vascular index (CAVI) Copyright©2019 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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Section: Discussionmentioning

confidence: 89%

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Satirapoj

Triwatana

Supasyndh

2020

JAT

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“…Moreover, all the microstructural and histologic nephrosclerosis signals increase in elderly patients. Another aging-related disease, such as hypertension or arterial stiffness, is related to a deterioration of renal function [51].…”

Section: Discussionmentioning

confidence: 99%

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Pochetti

Azzolina

Ragnoli

et al. 2020

IJERPH

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Previous studies showed a bidirectional relationship between renal function decline and obstructive sleep apnea (OSA) syndrome. Continuous Positive Airway Pressure (C-PAP) treatment was shown to preserve the kidney function in OSA patients. This study aims to investigate the progression of long-term renal function in OSA patients treated with different PAP strategies (patients were divided into two groups, fixed C-PAP or other PAP—automatic and bilevel pressure). Comorbidities and 10-years survival were also evaluated. We performed a retrospective, observational, single-center, cohort study, including the first 40 consecutive patients enrolled from 2009 in the Respiratory disease Unit at the Vercelli University Hospital database. The patient inclusion criteria were: age ≥ 18 years with OSA syndrome according to AASM (American Academy of Sleep Medicine) guidelines. Creatinine serum levels (mg/dL) and the estimated Glomerular Filtration Rate (eGFR, mL/min calculated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation)) were measured at 3 different time points: at baseline, 3 years and 8 years after PAP treatment. The Kaplan–Meier survival curves stratified according to PAP treatment and compliance have been reported together with log-rank test estimation. In our study, we found a significant creatinine serum level reduction after 3 years of fixed C-PAP treatment (p value = 0.006) when compared to baseline values. However, we observed that the long-term C-PAP benefit was not significant (p value = 0.060). Our data confirmed the progressive renal function decline in OSA patients, especially in those using other-PAP treatments; nevertheless, OSA treatment with a fixed C-PAP device has shown, in the short term, a significant improvement in renal function. By contrast, in our study, long-term benefits after 8 years are not been demonstrated probably because of the lack of compliance of the patients and the aging effect.

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“…Conversely, increased arterial stiffness can lead to deterioration of kidney function 4 . Whether there is a bidirectional association between increased arterial stiffness and decreased kidney function is unclear, but a recent study suggested that increased arterial stiffness affected the decline of kidney function uni-directionally 5 . This can be explained by the fact that increased arterial stiffness limits the dampening of ventricular ejection which transmits more pressure to the end organs 6 , and the increased pressure that is transmitted to the low-resistance renal afferent arterioles can damage the glomerular capillaries, resulting in reduced kidney function 7 .…”

Section: Introductionmentioning

confidence: 99%

“…Until now, many studies have suggested that increased arterial stiffness is associated with an increased risk of kidney function decline 4 , 5 , 14 – 16 . However, different results have also been reported 17 – 20 .…”

Section: Introductionmentioning

confidence: 99%

Relationship between brachial-ankle and heart-femoral pulse wave velocities and the rapid decline of kidney function

Lee

Han

Yoo

et al. 2018

Sci Rep

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The impact of brachial-ankle pulse wave velocity (baPWV) and heart-femoral pulse wave velocity (hfPWV) on rapid decline of estimated glomerular filtration rate (eGFR) has been inconclusive. The database of a multicenter prospective study of 2238 patients in Korea enrolled from 2011 to 2016 was reviewed. After excluding patients with missing baPWV (n = 257) and eGFR change (n = 180), the study included 1801 non-dialysis chronic kidney disease (CKD) patients. The eGFR change <−5ml/min/1.73 m2/year was defined as rapid decline. During a mean of 2.2 years, the mean eGFR change was −3.6 ml/min/1.73 m2/year, and 31.6% of patients were classified as having rapid decline. Older age, causes of CKD, increased heart rate, systolic blood pressures, and proteinuria were associated with the highest baPWV quintile. In multivariate logistic regression analyses, the odds of a rapid decline in eGFR was 1.9 times higher in the fifth quintile than in the first quintile (P = 0.013). In a subset with baPWV and hfPWV (n = 1182), high baPWV was associated with rapid eGFR decline only when accompanied by a high hfPWV. These findings suggest that central and peripheral PWVs may simultaneously affect rapid eGFR decline.

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Arterial stiffness and decline of renal function in a primary care population

Cited by 28 publications

References 36 publications

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study

Relationship between brachial-ankle and heart-femoral pulse wave velocities and the rapid decline of kidney function

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