Abstract 12601: Higher Arterial Stiffness Predicts Chronic Kidney Disease in the ELSA-Brasil Cohort Study

Abstract

Introduction: Arterial stiffening can directly affect the kidneys, which are passively perfused by a high flow. However, whether the relation between arterial stiffness and renal function is completely mediated by diabetes and hypertension (HTN) is a matter of debate. Objective: To investigate the relationship between arterial stiffness and the incidence of chronic kidney disease (CKD) in individuals without cardiovascular disease, and verify whether this association is mediated by HTN and diabetes. Methods: Baseline data of 13,068 adults from the ELSA-Brasil cohort (2008-2010, mean age 51 ± 9 years, 55% female) with validated carotid-to-femoral pulse wave velocity (cfPWV), estimated glomerular filtration rate (eGFR) estimated by the CKD-EPI equation, and albumin-to-creatinine ratio (ACR) were followed for 4 years (3.8 ± 0.42 years) to investigate the incidence of CKD. Arterial stiffness was measured by cfPWV, per quartile. CKD was defined as eGFR < 60ml/min/1.73m 2 and/or RAC ≥ 30mg/g. Logistic regression models were adjusted for age, sex, race, schooling, smoking, cholesterol/HDL, body mass index (BMI), diabetes, use of antihypertensive, mean arterial pressure, and heart rate. The same analyses were performed in the subsample free of HTN and diabetes at baseline. Results: In individuals in the upper quartile of cfPWV (10.1 to 27.9 m/s), the chance of incident CKD increased by 79% (CI 95%: 1.20; 2.68) and by 60% (CI 95% 1.01;2.52) when ACR was used. In the group free of HTN and diabetes, there was twice the chance of eGFR<60ml/min/1.73m 2 (OR 2.08 95%CI 1.17;3.69) and no association when CKD was measured by ACR. Conclusion: Our data indicate that higher values of cf-PWV is associated with incident CKD in adults, independent of diabetes or HTN.