Association of Arterial Rigidity with Incident Kidney Disease and Kidney Function Decline

Madero, Magdalena; Peralta, Carmen A.; Katz, Ronit; Canada, Robert B.; Fried, Linda P.; Najjar, Samer S.; Shlipak, Michael G.; Simonsick, Eleanor M.; Lakatta, Edward G.; Patel, Kushang V.; Rifkin, Dena E.; Hawkins, Marquis; Newman, Anne B.; Sarnak, Mark J.

doi:10.2215/cjn.07900812

Cited by 80 publications

(79 citation statements)

References 27 publications

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“…It is possible that circulating TGF-β is a more sensitive marker of CKD in older adults who have a higher prevalence of arterial stiffness. This is consistent with the role arterial stiffness plays in CKD in the elderly [21] and considering that TGF-β is induced in the arterial wall with aging [24].…”

Section: Discussionsupporting

confidence: 89%

“…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].…”

Section: Introductionmentioning

confidence: 99%

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

2015

American Journal of Kidney Diseases

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Background: TGF-β is induced in the vasculature with aging suggesting that high plasma TGF-β levels may be a risk factor for chronic kidney disease (CKD) in older adults. Methods: We conducted a cross-sectional analysis of the association between plasma TGF-β levels and CKD including data for 1722 older adults who had participated in the 1996/97 visit of the Cardiovascular Health Study (CHS). Prevalent CKD was defined as eGFR < 60 mL/min/1.73 m 2 or urinary albumin/creatinine ratio (ACR) ≥30 mg/g. We also evaluated whether baseline TGF-β levels predicted change in eGFR, cardiovascular (CV) events, or mortality in longitudinal analysis.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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

2015

American Journal of Kidney Diseases

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“…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).…”

Section: Discussionmentioning

confidence: 82%

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

et al. 2017

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Arterial stiffness is a risk factor for cardiovascular and chronic kidney disease. However, the role of arterial stiffness as a predictor of the age-related glomerular filtration rate (GFR) decline in the general population remains unresolved because of difficulty in measuring GFR with sufficient precision in epidemiological studies. The ambulatory arterial stiffness index (AASI) is a proposed indicator of arterial stiffness easily calculated from ambulatory blood pressure. We investigated whether AASI could predict GFR decline measured as iohexol clearance in the general population. We calculated AASI from baseline ambulatory blood pressure and measured the iohexol clearance at baseline and follow-up in the RENIS-FU study (Renal Iohexol Clearance Survey Follow-Up). AASI was defined as 1 minus the regression slope of the diastolic blood pressure measurement over the systolic blood pressure measurement for each patient. The RENIS cohort included a representative sample of the general middle-aged population without baseline diabetes mellitus, cardiovascular disease, or kidney disease (n=1608). The participant age was 50 to 62 years old at baseline, and the median observation time was 5.6 years. The mean (SD) of the GFR decline rate was 0.95 mL/min per year (2.23) and that of the AASI was 0.38 mL/min per year (0.13). Baseline ambulatory blood pressure or the night/day systolic or diastolic ambulatory blood pressure ratios were not associated with GFR decline. In multivariable-adjusted linear mixed regression analysis, 1 SD of increase in the baseline AASI was associated with a 0.14 mL/min per year (95% confidence interval, −0.26 to −0.02) steeper GFR decline. We conclude that the AASI is an independent risk factor for accelerated age-related GFR decline in the general middle-aged population.

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“…Previous studies on the association between arterial stiffness and decline in kidney function have been inconsistent (7,(9)(10)(11)(12)(13)(14)28). In a study including patients with CKD, Ford et al (9) showed that higher PWV but not pulse pressure was associated with the rate of change in kidney function.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated an independent association between arterial stiffness and decline in kidney function, but the results have been inconsistent (7)(8)(9)(10)(11)(12)(13)(14). Heterogeneity in the study populations and the limited power of the individual studies could underlie the inconsistent findings.…”

Section: Introductionmentioning

confidence: 99%

Arterial Stiffness and Decline in Kidney Function

Sedaghat¹,

Mattace-Raso²,

Hoorn³

et al. 2015

Clinical Journal of the American Society of Nephrology

135

112

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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.

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Association of Arterial Rigidity with Incident Kidney Disease and Kidney Function Decline

Cited by 80 publications

References 27 publications

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

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

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

Arterial Stiffness and Decline in Kidney Function

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