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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Brachial-ankle pulse wave velocity and rate of renal function decline and mortality in chronic kidney disease

Szu-Chia Chen1, Jer-Ming Chang, Wan-Chun Liu

  • 1Division of Nephrology, Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Clinical Journal of the American Society of Nephrology : CJASN
|April 2, 2011
PubMed

Insights

Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), independently predicts faster kidney function decline and progression to dialysis or death in chronic kidney disease (CKD) patients. Screening with baPWV can identify high-risk individuals.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biomedical Engineering

Background:

  • Arterial stiffness is linked to reduced kidney function (eGFR).
  • Previous research suggests arterial stiffness may influence chronic kidney disease (CKD) progression.
  • The role of arterial stiffness in CKD progression requires further investigation.

Purpose of the Study:

  • To determine if brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is independently associated with renal function decline in CKD patients.
  • To assess the predictive value of baPWV for progression to dialysis or death in CKD.
  • To investigate the relationship between baPWV and estimated glomerular filtration rate (eGFR) slope.

Main Methods:

  • A longitudinal study involving 145 patients with CKD stages 3-5.
  • Brachial-ankle pulse wave velocity (baPWV) measured using an ABI-form device.
  • Renal function change estimated by eGFR slope; study endpoints were dialysis initiation or death.

Main Results:

  • Multivariate analysis showed eGFR slope negatively associated with baPWV (β=-0.165, P=0.033).
  • Higher baPWV was independently associated with progression to dialysis or death (HR, 1.001; P=0.001) in Cox regression.
  • Lower baseline eGFR and higher serum phosphate also predicted progression.

Conclusions:

  • Brachial-ankle pulse wave velocity (baPWV) is independently associated with renal function decline in CKD patients.
  • Higher baPWV predicts progression to dialysis or death in CKD.
  • baPWV screening can identify CKD patients at high risk for rapid disease progression.
Abstract

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