Upstroke Time as a Novel Predictor of Mortality in Patients with Chronic Kidney Disease

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Biomedical Engineering

Background:

• Arterial stiffness and vascular injuries are significant concerns in chronic kidney disease (CKD).
• Upstroke time (UT), a peripheral pulse wave parameter, is utilized to assess arterial stiffness.
• Predictive markers for mortality in CKD patients are crucial for clinical management.

Purpose of the Study:

• To investigate the predictive capability of Upstroke time (UT) for cardiovascular and all-cause mortality in patients with CKD.
• To evaluate whether UT improves risk stratification beyond established factors.

Main Methods:

• A longitudinal study involving 472 CKD patients.
• Automated measurement of blood pressure, brachial pulse wave velocity (baPWV), and UT.
• Multivariable Cox regression and Kaplan-Meier analyses for mortality prediction.

Main Results:

• UT was significantly associated with both cardiovascular (HR=1.010, p=0.007) and all-cause mortality (HR=1.009, p<0.001).
• Incorporating UT into clinical models enhanced the prediction of mortality (p<0.001).
• Kaplan-Meier analysis showed UT ≥ 180 ms predicted mortality (log-rank p<0.001).

Conclusions:

• Upstroke time (UT) is a valuable and independent predictor of cardiovascular and all-cause mortality in CKD patients.
• UT provides incremental prognostic information beyond traditional risk factors and baPWV.
• Routine assessment of UT may benefit risk stratification in CKD management.