Related Experiment Video
Updated: May 2, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Aortic pulse wave velocity predicts mortality in chronic kidney disease stages 2-4
Marcus Baumann1, Siegfried Wassertheurer, Yana Suttmann
1aDepartment of Nephrology, Klinikum rechts der Isar, Technische Universität München, Germany bHealth & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria cNephrological Clinic Weissenburg, Weissenburg, Germany.
Insights
Increased aortic stiffness, measured by aortic pulse wave velocity (aPWV), strongly predicts mortality in patients with chronic kidney disease (CKD) stages 2-4. However, aPWV did not predict kidney disease progression in this cohort.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Chronic kidney disease (CKD) is linked to aortic stiffness and cardiovascular mortality.
- Aortic stiffness predicts mortality in end-stage renal disease, but its role in mild-to-moderate CKD is unclear.
Purpose of the Study:
- To investigate if aortic pulse wave velocity (aPWV) predicts mortality and renal disease progression in CKD patients stages 2-4.
Main Methods:
- 135 CKD patients (stages 2-4) had their aPWV assessed.
- The combined renal endpoint included a 50% decline in eGFR or initiation of renal replacement therapy.
Main Results:
- Aortic stiffness (aPWV ≥10 m/s) was associated with significantly increased mortality (log-rank P<0.05).
- aPWV independently predicted mortality in CKD stages 2-4 (HR 5.1).
- aPWV did not predict renal disease progression (log-rank P=0.90).
Conclusions:
- Increased aortic stiffness, determined by aPWV, is a significant independent predictor of all-cause mortality in CKD stages 2-4.
- aPWV is a valuable prognostic marker for mortality in this patient population.
Background:
Chronic kidney disease (CKD) is characterized by aortic stiffness and increased cardiovascular mortality. In end-stage renal disease, aortic stiffness predicts mortality, whereas this role remains uncertain in mild-to-moderate CKD. We aimed to investigate whether aortic pulse wave velocity (aPWV) predicts mortality and renal disease progression in CKD patients.
Methods:
We enrolled 135 CKD patients stages 2-4 [estimated glomerular filtration rate (eGFR): 41.1 (28.5-61.6) ml/min per 1.73 m] in the study and assessed aPWV. The combined renal end-point was defined as at least 50% decline in renal function and/or start of renal replacement therapy.
Results:
During the observational period of 42 (30-50) months six patients were lost of follow-up, 13 patients died and 16 patients reached the combined renal end-point. Stratification according to the mean of aPWV (10 m/s), Kaplan-Meier analysis revealed increased mortality with aPWV ≥10 m/s (log-rank P < 0.05). Stepwise logistic regression analysis confirmed aPWV as an independent predictor for mortality in CKD stage 2-4. The hazard ratio of mortality in the cohort with an aPWV at least 10 m/s was 5.1 (1.1-22.9). By contrast, Kaplan-Meier analysis revealed no effect of aPWV on the combined renal end-point (log-rank P = 0.90).
Discussion:
These results provide the first direct evidence that in patients with CKD stage 2-4, increased aortic stiffness determined by aPWV is a strong independent predictor of all-cause mortality.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Chronic Kidney Disease I: Introduction
01:29Acute Kidney Injury II: Pathophysiology
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:18Chronic Kidney Disease IV: Nursing Management