Arterial stiffness evaluated by carotid-femoral pulse wave velocity increases the risk of chronic kidney disease in a Chinese population-based cohort.

ABSTRACT

AIM: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Although pulse wave velocity (PWV), which reflects arterial stiffness, was increased in subjects with CKD, little is known regarding whether arterial stiffness can increase the risk of CKD. To help clarify this we conducted a prospective cohort study to measure the association of arterial stiffness with CKD. METHODS: A total of 7154 adults aged 54.8 ± 10.6 years undergoing physical examinations without CKD at baseline were enrolled. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cfPWV). CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min per 1.73 m2 ) or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method. RESULTS: During 3 years of follow-up, 167 (2.3%) patients developed CKD, 101 (1.4%) patients with proteinuria and 68 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, either cfPWV (per 1 m/s increase) or the highest quartile of cfPWV (increased cfPWV) was independently associated with increased risk of proteinuria, with a fully adjusted OR of 1.15 (95% CI, 1.07 to 1.23) and 1.93 (95% CI, 1.15 to 3.25), respectively. By contrast, neither cfPWV (per 1 m/s increase) nor increased cfPWV was associated with decreased eGFR in the multivariable logistic regression analysis. CONCLUSIONS: The study revealed that arterial stiffness increases the risk of proteinuria. This suggests that vascular stiffness could be considered as a target for delaying the development of CKD.