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Updated: May 14, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Determinants of arterial stiffness in chronic kidney disease stage 3
Natasha J McIntyre1, Richard J Fluck, Christopher W McIntyre
1Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom.
Insights
In early chronic kidney disease (CKD), arterial stiffness (AS) is primarily determined by age and traditional cardiovascular risk factors, not kidney function. Further research will explore AS as an independent risk factor for cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Biology
Background:
- Early chronic kidney disease (CKD) is linked to elevated cardiovascular (CV) risk, but the underlying mechanisms are not fully understood.
- While arterial stiffness (AS) is a known CV risk factor in advanced CKD, its role in early stages remains unclear.
Purpose of the Study:
- To investigate the determinants of arterial stiffness (AS) in patients with early chronic kidney disease (CKD).
- To assess the relationship between AS, estimated glomerular filtration rate (eGFR), albuminuria, and traditional cardiovascular risk factors in this population.
Main Methods:
- A cross-sectional study involving 1717 patients with early CKD (eGFR 59-30 mL/min/1.73 m²).
- Carotid-to-femoral pulse wave velocity (PWV) was measured to assess arterial stiffness (AS).
- Data collected included medical history, clinical assessment, and biochemical testing, with multivariable analysis used to identify determinants of PWV.
Main Results:
- Age, mean arterial pressure (MAP), and diabetes were identified as the strongest independent determinants of higher arterial stiffness (AS).
- Arterial stiffness (AS) was significantly higher in males, diabetics, and individuals with prior cardiovascular events.
- Albuminuria showed a weaker association with AS, and eGFR was not an independent determinant in multivariable analysis.
Conclusions:
- In early CKD, arterial stiffness (AS) is predominantly influenced by age and established cardiovascular risk factors.
- Kidney function (eGFR) and albuminuria appear to be less critical determinants of AS in this early stage of CKD.
- Long-term follow-up is planned to determine if AS independently predicts cardiovascular events in this cohort.
Background:
Early chronic kidney disease (CKD) is associated with increased cardiovascular (CV) risk but underlying mechanisms remain uncertain. Arterial stiffness (AS) is associated with increased CV risk in advanced CKD, but it is unclear whether AS is relevant to CV disease (CVD) in early CKD.
Study Design:
Cross-sectional.
Setting And Participants:
1717 patients with previous estimated glomerular filtration rate (eGFR) 59-30 mL/min/1.73 m(2); mean age 73±9y, were recruited from 32 general practices in primary care.
Outcomes:
Increased arterial stiffness.
Measurements:
Medical history was obtained and participants underwent clinical assessment, urine and serum biochemistry testing. Carotid to femoral pulse wave velocity (PWV) was determined as a measure of AS, using a Vicorder™ device.
Results:
Univariate analysis revealed significant correlations between PWV and risk factors for CVD including age (r = 0.456; p<0.001), mean arterial pressure (MAP) (r = 0.228; p<0.001), body mass index (r = -0.122; p<0.001), log urinary albumin to creatinine ratio (r = 0.124; p<0.001), Waist to Hip ratio (r = 0.124, p<0.001), eGFR (r = -0.074; p = 0.002), log high sensitivity c-reactive protein (r = 0.066; p = 0.006), HDL (r = -0.062; p = 0.01) and total cholesterol (r = -0.057; p = 0.02). PWV was higher in males (9.6 m/sec vs.10.3 m/sec; p<0.001), diabetics (9.8 m/sec vs. 10.3 m/sec; p<0.001), and those with previous CV events (CVE) (9.8 m/s vs. 10.3 m/sec; p<0.001). Multivariable analysis identified age, MAP and diabetes as strongest independent determinants of higher PWV (adjusted R² = 0.29). An interactive term indicated that PWV increased to a greater extent with age in males versus females. Albuminuria was a weaker determinant of PWV and eGFR did not enter the model.
Limitations:
Data derived from one study visit, with absence of normal controls.
Conclusion:
In this cohort, age and traditional CV risk factors were the strongest determinants of AS. Albuminuria was a relatively weak determinant of AS and eGFR was not an independent determinant. Long-term follow-up will investigate AS as an independent risk factor for CVE in this cohort.
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