Abstract P536: The Association Between Arterial Stiffness and Incident Chronic Kidney Disease in a Large Community Cohort: The Atherosclerosis in Communities (ARIC) Study

Abstract

Background: Arterial stiffness was cross-sectionally associated with the prevalence of chronic kidney disease (CKD). Whether arterial stiffness was prospectively associated with incident CKD is not well characterized. Methods: Among 3,777 participants (mean age 75 years old, 42.7% female, 21.3% Blacks) without prevalent CKD in ARIC study at visit 5 (2011 to 2013), we examined the association of six measures for arterial stiffness measurements, carotid-femoral pulse wave velocity (cfPWV), heart-ankle PWV (haPWV), brachial-ankle PWV (baPWV), heart-femoral PWV (hfPWV), femoral-ankle PWV (faPWV), heart-carotid PWV (hcPWV) with the risk of incident CKD (defined by >25% decline to estimated glomerular filtration rate <60 ml/min/1.73m 2 or hospitalization with CKD diagnosis) using Cox regression models to estimate hazard ratios (HRs). Each arterial stiffness parameter was stratified by quartiles. Results: During follow-up (median 6.6 years) through 2019, 590 had incident CKD (incidence rate 23.2 per 1000 person-years). In the demographically adjusted model, the highest quartile (Q4) of cfPWV, haPWV, baPWV, and hfPWV were significantly associated with an increased risk of incident CKD compared to the lowest (Q1) (HR, 1.70 [95%CI 1.31 to 2.22], 1.29 [95% CI 1.01 to 1.64], 1.51 [95% CI 1.16 to 1.97], and 1.36 [95% CI 1.05 to 1.76], respectively). Once the model was further adjusted for major clinical risk factors for CKD, the associations were modestly attenuated but remained significant for cfPWV and haPWV (HR in Q4 vs. Q1, 1.34 [95% CI 1.02 to 1.76] and 1.38 [95% CI 1.04 to 1.82]), but not for baPWV and hfPWV. Subgroup analyses showed the associations were consistent in subgroups by gender, race, age, hypertension, and diabetes. Conclusion: Arterial stiffness as measured by PWV was associated with a higher risk of incident CKD in older adults, especially cfPWV and haPWV. Our findings support the temporal relationship of subclinical arterial stiffness predating incident CKD in older adults.