MO507: Prediction of CKD Progression and Cardiovascular Events Using Pulse Wave Velocity and Albuminuria

Abstract

Abstract BACKGROUND AND AIMS Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD) and death. Albuminuria has been identified as a risk factor, however, additional biomarkers predicting CKD progression and CVD are needed. Arterial stiffness is an easily measurable candidate that has been associated with CVD and mortality. We compared the ability of carotid-femoral pulse wave velocity (PWV) and urine albumin-creatinine (UAC) ratios to predict CKD progression, cardiovascular events (myocardial infarction or stroke) and mortality in a cohort of CKD patients. METHOD In stage, CKD stage 3–4 patients PWV and UAC were measured at baseline. The endpoint of CKD progression was defined as a 50% decline in estimated glomerular filtration rate (eGFR), the initiation of dialysis or renal transplantation. The composite endpoint was defined as the CKD progression endpoint, myocardial infarction, stroke or death. Endpoints were analyzed in a Cox regression analysis adjusted for age, gender, blood pressure, baseline eGFR, BMI and including both PWV and UAC. Data were collected from individual patient biochemistry files, the Danish National Nephrology Registry and the Danish Health Data Registry. RESULTS We included 182 patients [median age 69 (interquartile range 60–75) years, 68% males] with a mean eGFR 37 ± 12 mL/min/1.73 m2 and a UAC of 52 (5–453) mg/g. The mean PWV was 10.6 m/s. The median follow-up until the first event was 4 (3–6) years, with 44 and 89 patients reaching the CKD progression and the composite endpoints, respectively. UAC (mg/g) significantly predicted both the CKD endpoint [HR: 1.0005 (1.0002–1.0008)] and the composite endpoint [HR 1.0004 (1.0001–1.0007)] in adjusted cox regression. In contrast, PWV (m/s) was not associated with the CKD endpoint [HR: 0.99 (0.84–1.18)] nor the composite endpoint (HR: 1.03 (0.92–1.15)]. CONCLUSION In an ageing CKD population, UAC predicted both CKD progression and a composite endpoint of CKD progression, cardiovascular events, or death, while PWV at baseline did not.