Aortic PWV in chronic kidney disease: a CRIC ancillary study

Raymond R Townsend, Neil J Wimmer, Julio A Chirinos, Afshin Parsa, Matthew Weir, Kalyani Perumal, James P Lash, Jing Chen, Susan P Steigerwalt, John Flack, Alan S Go, Mohammed Rafey, Mahboob Rahman, Angela Sheridan, Crystal A Gadegbeku, Nancy A Robinson, Marshall Joffe, Raymond R Townsend, Neil J Wimmer, Julio A Chirinos, Afshin Parsa, Matthew Weir, Kalyani Perumal, James P Lash, Jing Chen, Susan P Steigerwalt, John Flack, Alan S Go, Mohammed Rafey, Mahboob Rahman, Angela Sheridan, Crystal A Gadegbeku, Nancy A Robinson, Marshall Joffe

Abstract

Background: Aortic pulse wave velocity (PWV) is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end-stage renal disease receiving hemodialysis. Little data exist characterizing aortic stiffness in patients with chronic kidney disease (CKD) who are not receiving dialysis, and in particular the effect of reduced kidney function on aortic PWV.

Methods: We performed measurements of aortic PWV in a cross-sectional cohort of participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased aortic PWV in CKD.

Results: PWV measurements were obtained in 2,564 participants. The tertiles of aortic PWV (adjusted for waist circumference) were <7.7 m/s, 7.7-10.2 m/s, and >10.2 m/s with an overall mean (+/- s.d.) value of 9.48 +/- 3.03 m/s (95% confidence interval = 9.35-9.61 m/s). Multivariable regression identified significant independent positive associations of age, blood glucose concentrations, race, waist circumference, mean arterial blood pressure, gender, and presence of diabetes with aortic PWV and a significant negative association with the level of kidney function.

Conclusions: The large size of this unique cohort, and the targeted enrollment of CKD participants provides an ideal situation to study the role of reduced kidney function as a determinant of arterial stiffness. Arterial stiffness may be a significant component of the enhanced cardiovascular risk associated with kidney failure.

Conflict of interest statement

Conflict of Interest Statement: The Corresponding author (RRT) received funding from the NIH/NIDDK. There is no other COI to declare.

Figures

FIGURE 1
FIGURE 1
Histogram depicting frequency of adjusted (for waist circumference) aortic PWV (PWV) in shaded bars (foreground) grouped in units of 1.5 meters/second in the CKD population of the CRIC study. The distribution of the unadjusted aortic PWV is shown in open bars (background) for reference.
FIGURE 2
FIGURE 2
Mean ± S.D. of aortic PWV by race (C=Caucasian; AA=African American/Black; O=Other) and gender (M=Men; W=Women).
FIGURE 3
FIGURE 3
Mean ± S.D. aortic PWV plotted against age in 10 year increments separated within each 10 year interval by the absence (open bar) or presence (shaded bar) of diabetes.
FIGURE 4
FIGURE 4
Mean ± S.D. aortic PWV plotted against estimated glomerular filtration rate (eGFR) in 10 mL/min/1.73m2 increments.

Source: PubMed

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