Association between Arterial Stiffness and Estimated Glomerular Filtration Rate in the Japanese General Population

Abstract

Aim: Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease, although it has yet to be established whether CKD is an independent risk factor for arterial stiffness in community residents. The purpose of this study was to determine the correlation between the cardio-ankle vascular index (CAVI) and estimated glomerular filtration rate (eGFR) in the general population. Methods: We studied 881 consecutively enrolled subjects undergoing health checkups. CAVI was calculated automatically from the pulse volume record, blood pressure and the vascular length from the heart to the ankle. CKD was evaluated by the eGFR. . It has been reported that microalbuminuria is a strong determinant of ischemic heart disease and death, independent of age, sex, hypertension, diabetes mellitus, renal function and the plasma lipid profile 6) . As a consequence, mild renal dysfunction has recently attracted increased attention, with a reduction in the estimated glomerular filtration rate (eGFR) being regarded as a useful index of kidney damage and also an effective strategy for detecting patients with CKD 7). Recently, an atherosclerotic index, the cardioankle vascular index (CAVI), has been developed that involves measuring pulse wave velocity (PWV) and blood pressure (BP). CAVI is adjusted for BP based on the stiffness parameter and is expressed as arterial stiffness independent of BP 8, 9) . We have reported previously that CAVI showed a weaker correlation IntroductionChronic kidney disease (CKD) is a worldwide public health problem 1) . Cardiovascular disease (CVD) is associated frequently with CKD, a relationship that is important given that individuals with CKD are more likely to die of CVD than to develop kidney failure 2) . Numerous studies have established that CKD is a major risk factor for CVD, not only in populations at high risk for CVD, but also in the general

Stroke patients with cerebral microbleeds on MRI scans have arteriolosclerosis as well as systemic atherosclerosis

“…Moreover, previous studies have established a strong association between the CAVI and small-vessel disease of other organs. 23,24 Kubozono et al 23 reported a relationship between the CAVI and a low estimated glomerular filtration rate. Kim et al 24 identified a correlation between the CAVI and microvascular complications in type 2 diabetes mellitus patients without a history of macrovascular disease.…”

Serum Osteoprotegerin is Associated with Arterial Stiffness Assessed According to the Cardio-ankle Vascular Index in Hypertensive Patients

“…In the current analysis, we found that the SBP, DBP and pulse pressure values were higher in the high arterial stiffness group than in the low arterial stiffness group. The CAVI correlates independently with the estimated GFR in the general Japanese population 24) , whereas, in renal insufficiency patients, the CAVI values are closely associated with the cystatin C levels 25) . Another report noted a significant correlation between the serum cystatin C level and the CAVI only in women in a non-chronic kidney disease population 26) .…”

Age-specific distribution of estimated glomerular filtration rate using Japanese health checkup data

“…A GFR < 60 mL/min/1.73 m 2 , which is associated with a gradual increase in the risk for CVD, ESRD, and mortality, is the threshold value for the definition of CKD 8) . CKD has been linked with arterial stiffness in the Japanese general population 9) and a low eGFR and pronounced albuminuria have been found to independently predict mortality and ESRD 10) ; moreover, reduced eGFR has been identified as a predictor of CVD and all-cause mortality in Japan 11) . eGFR is also used, along with urinary protein (albumin) quantification and determination of the primary disease, in CKD severity classification, which determines the risk for CVD and ESRD, as well as mortality 1) .…”