Mild Chronic Kidney Disease Associated with Greater Risk of Arterial Stiffness in Elderly Adults

Abstract

To assess the association between arterial stiffness and mild and moderate chronic kidney disease (CKD), independent of other cardiometabolic factors in an elderly population. Cross-sectional study. Health examination data from National Cheng Kung University Hospital from 2006 to 2009. Eligible subjects aged 60 and older (N = 1,251). An average bilateral brachial-ankle pulse wave velocity (baPWV) of 1,400 cm/s or greater was defined as high baPWV. Based on the 2003 Clinical Practice Guidelines for Chronic Kidney Disease from the National Kidney Foundation, mild and moderate CKD were defined as CKD Stages 1 and 2 and Stages 3 to 5, respectively. Participants with a baPWV of 1,400 cm/s or greater (n = 1,028) had lower estimated glomerular filtration rates (eGFRs) but higher serum creatinine levels and greater prevalences of mild and moderate CKD, diabetes mellitus, prediabetes mellitus, hypertension, and prehypertension than those with baPWV less than 1,400 cm/s (n = 223). In the multivariate analysis, mild (odds ratio (OR) = 2.58, 95% confidence interval (CI) = 1.02-6.54) and moderate (OR = 3.75, 95% CI = 1.02-13.81) CKD were positively associated with greater baPWV (≥1,400 cm/s). Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also independently associated with greater baPWV. In the multiple linear analysis, moderate (β = 120.45, P < .001) and mild CKD (β = 69.90, P = .01) were positively associated with baPWV. There was also an independently inverse correlation between eGFR and baPWV (β = -0.69, P = .04). Mild and moderate CKD increased the risk of greater arterial stiffness in elderly adults. Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also important correlates of increased arterial stiffness.