Abstract
PurposeAn increase in arterial stiffness is associated with rapid renal function decline (RFD) in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether the radial augmentation index (rAI), a surrogate marker of arterial stiffness, affects RFD in individuals without CKD.MethodsA total of 3165 Chinese participants from an atherosclerosis cohort with estimated glomerular filtration rates (eGFR) of ≥ 60 mL/min/1.73 m2 were included in this study. The baseline rAI normalized to a heart rate of 75 beats/min (rAIp75) was obtained using an arterial applanation tonometry probe. The eGFRs at both baseline and follow-up were calculated using the equation derived from the Chronic Kidney Disease Epidemiology Collaboration. The association of the rAIp75 with RFD (defined as a drop in the eGFR category accompanied by a ≥ 25% drop in eGFR from baseline or a sustained decline in eGFR of > 5 mL/min/1.73 m2/year) was evaluated using the multivariate regression model.ResultsDuring the 2.35-year follow-up, the incidence of RFD was 7.30%. The rAIp75 had no statistically independent association with RFD after adjustment for possible confounders (adjusted odds ratio = 1.12, 95% confidence interval: 0.99–1.27, p = 0.074). When stratified according to sex, the rAIp75 was significantly associated with RFD in women, but not in men (adjusted odds ratio and 95% confidence interval: 1.23[1.06–1.43], p = 0.007 for women, 0.94[0.76–1.16], p = 0.542 for men; p for interaction = 0.038).ConclusionThe rAI might help screen for those at high risk of early rapid RFD in women without CKD.
Highlights
Chronic kidney disease (CKD) is increasingly recognized as a global public health problem, which affects 7–12% of the adult population in different regions of the world
Previous observational studies have provided solid evidence that arterial stiffness is associated with a faster decline in the estimated glomerular filtration rate in CKD patients [7,8,9,10]
As the relationship between the radial augmentation index (rAI) and renal function in individuals without CKD is not well understood, we examined this relationship in a Chinese community population with an estimated glomerular filtration rate (eGFR) of ≥ 60 mL/min/1.73 m2
Summary
Chronic kidney disease (CKD) is increasingly recognized as a global public health problem, which affects 7–12% of the adult population in different regions of the world. Patients with CKD have a significantly increased risk of death, mainly due to cardiovascular disease that is followed. The cushioning function of the arterial system, which converts the pulsed blood flow from the heart to the continuous blood flow of the capillaries, decreases [3, 4]. Renal microcirculation is exposed to highpressure pulsatility, which may result in glomerular endothelial dysfunction and decreased renal arterial volume [5, 6]. Previous observational studies have provided solid evidence that arterial stiffness is associated with a faster decline in the estimated glomerular filtration rate (eGFR) in CKD patients [7,8,9,10]. There is no consensus yet on whether an association between arterial stiffness and
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