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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.6K

Arterial stiffness and kidney disease progression in the systolic blood pressure intervention trial


Kristen L Nowak, Michel Chonchol, Anna Jovanovich

    Clinical Nephrology
    |May 26, 2020
    PubMed

    Insights

    Higher baseline pulse pressure (PP) is linked to faster kidney disease progression in older adults, particularly those without chronic kidney disease (CKD). This finding highlights PP as a key indicator for monitoring kidney health in at-risk populations.

    Area of Science:

    • Nephrology
    • Cardiovascular Medicine
    • Geriatrics

    Background:

    • Arterial stiffness, a marker of cardiovascular and kidney health, increases with age and in chronic kidney disease (CKD).
    • The relationship between arterial stiffness and kidney function decline is not fully understood, necessitating further investigation.
    • Pulse pressure (PP) and carotid-femoral pulse-wave velocity (CFPWV) are key indicators of arterial stiffness.

    Purpose of the Study:

    • To investigate the independent association between baseline arterial stiffness (measured by PP and CFPWV) and kidney disease progression.
    • To determine if arterial stiffness predicts kidney function decline in participants of the Systolic Blood Pressure Intervention Trial (SPRINT).

    Main Methods:

    • Analysis included 8,815 SPRINT participants for PP and 592 for CFPWV.
    • Cox proportional hazards analysis assessed the association between PP and kidney disease progression endpoints.
    • Mixed models examined the relationship between baseline PP/CFPWV and estimated glomerular filtration rate (eGFR) changes.

    Main Results:

    • Higher baseline PP (≥ median) was significantly associated with an increased hazard of kidney disease progression (HR: 1.93).
    • This association was significant in individuals without baseline CKD (HR: 2.05) but not in those with baseline CKD (HR: 1.28).
    • Higher baseline PP was strongly associated with eGFR decline (p < 0.0001), while baseline CFPWV was not.

    Conclusions:

    • Baseline pulse pressure is an independent predictor of kidney disease progression in older adults at high cardiovascular risk.
    • The association between PP and kidney disease progression is more pronounced in individuals without pre-existing CKD.
    • Pulse pressure may serve as a valuable clinical marker for identifying individuals at risk of kidney function decline.
    Abstract

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