Abstract
BackgroundArterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, particularly among individuals without hypertension and diabetes. We investigated the cross-sectional associations between arterial stiffness and renal function in adults without cardiovascular disease, and whether this association remained among subjects without hypertension and diabetes.MethodsAll eligible participants from ELSA-Brasil (2008–2010), aged 35 to 74 years (N = 13,586) were included, of whom 7,979 were free from hypertension and diabetes. The response variables were: 1) low glomerular filtration rate (eGFR<60ml/min/1.73m2) estimated by CKD-EPI; 2) increased albumin/creatinine ratio (ACR ≥30mg/g); and 3) chronic kidney disease (CKD). Arterial stiffness was ascertained by the carotid-femoral pulse wave velocity (PWV). The covariates were sex, age, race/color, level of schooling, smoking, body mass index, total cholesterol/HDL-c glycated hemoglobin, diabetes, systolic blood pressure, heart rate and use of antihypertensive drugs. Logistic regression was used to examine the associations.ResultsAfter all adjustments, 1 m/s increase in PWV was associated with ORs equal to 1.10 (95%CI: 1.04–1.16), 1.10 (95%CI: 1.05–1.16) and 1.12 (95%CI: 1.08–1.17) of low eGFR, high ACR, and CKD, respectively. In subjects without hypertension and diabetes, these ORs were 1.19 (95%CI: 1.07–1.33), 1.20 (95%CI: 1.07–1.32) and 1.21 (95%CI: 1.11–1.30), respectively.ConclusionThe increase in PWV was associated with all renal dysfunction markers, even in individuals without hypertension and diabetes, suggesting a relation that is not completely mediated by the presence of these conditions.
Highlights
Arterial stiffness results from a structural change in the arteries related to excess production of collagen fibers and/or abnormal loss of elastin
1 m/s increase in pulse wave velocity (PWV) was associated with ORs equal to 1.10, 1.10 (95%CI: 1.05–1.16) and 1.12 (95%CI: 1.08–1.17) of low estimated glomerular filtration rate (eGFR), high albumin/creatinine ratio (ACR), and chronic kidney disease (CKD), respectively
Aortic stiffness and renal dysfunction in the ELSA-Brasil information on the distribution of response variables and the explanatory variable, according to age (5 in 5 years) and sex are included as supplementary tables to the manuscript
Summary
Arterial stiffness results from a structural change in the arteries related to excess production of collagen fibers and/or abnormal loss of elastin. It is an established risk factor for cardiovascular disease (CVD) and has been associated with the incidence and progression of chronic kidney disease (CKD) [1,2] and cardiovascular mortality in patients with CKD [3,4]. Arterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, among individuals without hypertension and diabetes. We investigated the cross-sectional associations between arterial stiffness and renal function in adults without cardiovascular disease, and whether this association remained among subjects without hypertension and diabetes.
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