The cardio-ankle vascular index predicts chronic kidney disease in Japanese subjects

Abstract

ObjectiveChronic kidney disease (CKD) is known to be associated with the incidence and mortality of cardiovascular disease. Therefore, the prevention of CKD may improve the mortality of cardiovascular disease. The risk factors of CKD are variable and multifactorial, similar to atherosclerosis. We hypothesized that the index of atherosclerosis predicts future CKD, and investigated the association between the cardio-ankle vascular index (CAVI), the index of arterial stiffness in part of atherosclerosis, and CKD occurrence in non-CKD patients. MethodsOf the 1000 patients undergoing CAVI in our hospital from 2006 to 2007 without CKD, we followed renal function for 1 or more years in 369 patients. CKD was defined as an estimated glomerular filtration rate of <60 ml/min/1.73 m2. ResultsWe divided our study patients into 4 groups according to their CAVI: <8.0 (n = 85), 8.0–9.0 (n = 75), 9.0–10.0 (n = 112), and ≥10.0 (n = 97), respectively. The differences in serum creatinine between baseline and follow-up were 0.09 ± 0.04, 0.11 ± 0.05, 0.17 ± 0.04 and 0.23 ± 0.04, respectively (the P value for the lowest group versus the highest group was 0.04). The age- and sex-adjusted odds ratios (95% confidential interval, P value versus the lowest group) for the occurrence of CKD were 1.13 (0.58–2.20, P = 0.09), 1.58 (0.85–2.94, P = 0.09), and 2.38 (1.23–4.61, P = 0.02). Even after multivariate adjustment, the relationship remained. ConclusionCAVI was found to be associated with future renal dysfunction, thus suggesting that a CAVI ≥10 may therefore be a risk factor for CKD in Japanese patients.