Estimated glomerular filtration rate and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study

Abstract

Background Evidence regarding the relationship between estimated glomerular filtration rate (eGFR) and arterial stiffness is limited, and the data analysis is not sufficient to clarify the true relationship between the two. We aimed to investigate the relationship between eGFR and brachial-ankle pulse wave velocity (baPWV) in Japanese. Methods The present study was a cross-sectional study. Nine hundred twelve Japanese men and women, aging 24—84 years old, received a health medical check-up program including the results from baPWV inspection and various standardized questionnaires in a health examination center in Japan. The main outcome measures included eGFR, baPWV, fatty liver and postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. Postmenopausal state was defined as beginning 1 year after the cessation of menses. Results The average age of the 912 selected participants was 51.5 ± 9.6 years old, and about 57.6% of them were male. The participants’ eGFR distribution was median 69.29 (min 39, max 122.28). The results of multivariate linear regression showed eGFR was not independently associated with baPWV after adjusting potential confounders (β = − 1.11, 95%CI -2.25 to 0.03), this is inconsistent with the result of eGFR (quartile) as a categorical variable (p for trend was 0.038). A non-linear relationship was detected between eGFR and baPWV, whose point was 77.05. The effect sizes and the confidence intervals of the left and right sides of inflection point were − 2.80 (− 4.41 to − 1.19) and 1.84 (− 0.50, 4.17), respectively. Subgroup analysis showed, the change in the elderly population is more pronounced (P for interaction = 0.018; − 2.83 with ≤60 year vs − 6.12 with > 60 year). The same trend was also seen in hypertensive people (P for interaction = 0.018; − 4.55 with hypertension vs − 0.82 with non-hypertension). Conclusion The relationship between eGFR and baPWV is non-linear. eGFR was negatively related to baPWV when eGFR is less than 77.05.

Relationship between Arterial Stiffness and Renal Function Determined by Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) and Modification of Diet in Renal Disease (MDRD) Equations in a Chinese Cohort Undergoing Health Examination

“…In our study, all renal function formulas showed a significant correlation. It should be noted that some studies have not found a link between mild renal impairment and arterial stiffness [ 10 , 11 ]. These two studies, respectively, adopted the Japanese Society of Nephrology model and MDRD formula to calculate eGFR.…”

“…There are many formulas for calculating renal function in CKD patients, and the correlation between different formulas and arterial stiffness is still controversial. A study has suggested that the relationship between estimated glomerular filtration rate (eGFR) and arterial stiffness is nonlinear [ 10 ]. Moderate to severe renal impairment is associated with increased arterial stiffness.…”

Triglyceride affects the association between estimated glomerular filtration rate and the onset of non-alcoholic fatty liver disease: A second analysis of a Chinese cohort study

“…Participants were stratified by eGFR quartile into Q1 (<82.88 ml/min/1.73 m 2 ), Q2 (≥82.88, <99.70), Q3 (≥99.70, <116.56), and Q4 (≥116.56) groups (43)(44)(45). For continuous variables, the mean (standard deviation) or median (range) (non-normal distribution) was used, and for categorical variables, the number (%) was used.…”

Recycling of predictors used to estimate glomerular filtration rate: Insight into lateral collinearity

“…In order to reduced lateral collinearity we must avoid the reuse of predictors that were already used to estimate the outcome. Then this type of bias occurs when the outcome is derived from the predictors [4][5][6] as in body mass index (BMI), which is calculated as a function of height, and weight, and the KDPI, which is calculated using 6 donors variables. As an example of lateral collinearity in the study by Das et al [10], glomerular filtration was estimated with laboratory data and conclusions are drawn from regression based on age, ethnicity, and sex, variables that are also used to estimate GFR.…”

“…The estimated glomerular filtration rate (eGFR), calculated using age, ethnicity, gender and creatinine values in the MDRD [1] and CKD-EPI [2] equations, has been used as an appropriate surrogate for glomerular function [3]. The eGFR has been used as an outcome in several epidemiological studies [4][5] including in transplantation [6] and is frequently considered as a surrogate marker in clinical studies.…”