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Updated: Dec 11, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Aortic pulse wave velocity, central pulse pressure, augmentation index and chronic kidney disease progression in
Jian-Jun Liu1, Sylvia Liu1, Janus Lee1
1Clinical Research Unit, Khoo Teck Puat hospital, Singapore, 768828, Republic of Singapore.
Insights
Pulse wave velocity (PWV) is independently linked to chronic kidney disease (CKD) progression in type 2 diabetes. Lowering PWV may reduce CKD risk and improve patient risk stratification.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Diabetes Research
Background:
- Arterial stiffness parameters like pulse wave velocity (PWV), central pulse pressure, and augmentation index are linked to hemodynamics.
- Their association with renal outcomes, particularly progressive chronic kidney disease (CKD), remains debated.
- This study investigates the independent association of these parameters with CKD progression.
Purpose of the Study:
- Identify which hemodynamic parameter independently predicts progressive CKD in type 2 diabetes.
- Assess the relationship between 3-year changes in PWV and CKD progression.
- Evaluate the additive predictive value of PWV for progressive CKD.
Main Methods:
- Carotid-femoral PWV, central pulse pressure, and augmentation index were measured in 1444 type 2 diabetes patients.
- Measurements were taken at baseline and after a 3-year follow-up.
- Progressive CKD was defined as a confirmed 40% or greater decline in estimated glomerular filtration rate (eGFR).
Main Results:
- Of 102 participants with progressive CKD, all three hemodynamic parameters showed univariable associations.
- Only PWV remained a significant independent predictor of progressive CKD after multivariable adjustment (OR 1.14 per m/s increment).
- A 1 m/s decrease in PWV over 3 years was associated with a 26% lower adjusted risk of progressive CKD (OR 0.74).
- Adding PWV to traditional risk models significantly improved classification and prediction rates for progressive CKD.
Conclusions:
- Pulse wave velocity (PWV) is the sole arterial stiffness parameter independently associated with progressive CKD in this cohort.
- PWV presents a potential therapeutic target for mitigating CKD progression.
- PWV can serve as a valuable biomarker for enhancing risk stratification of adverse renal outcomes in type 2 diabetes.
Background:
Pulse wave velocity (PWV), central pulse pressure and augmentation index are arterial stiffness- related hemodynamic parameters but their associations with renal outcome are still controversial. We hereby aim to study, 1) which hemodynamic parameter is independently associated with progressive chronic kidney disease (CKD), 2) the association of 3-year change in PWV with CKD progression and, 3) the additive predictive value of PWV for progressive CKD.
Methods:
Carotid- femoral PWV, central pulse pressure and augmentation index were measured in 1444 participants with type 2 diabetes at baseline and 3 years apart. Progressive CKD was defined as confirmed eGFR decline 40% or greater.
Results:
In the follow-up, 102 participants experienced progressive CKD. All 3 hemodynamic parameters were significantly associated with progressive CKD In univariable analysis. However, only PWV remained statistically significant after adjustment for known clinical risk factors and the other 2 hemodynamic parameters (OR 1.14 [95% CI 1.01-1.29] per m/s increment). One m/s regression (decrement) in PWV in the 3-year follow-up was associated with 26% lower adjusted- risk of progressive CKD (OR 0.74, 95% CI 0.56-0.97). Adding PWV onto traditional risk factor- based model significantly improved classification (net reclassification improvement 0.25, 95% CI 0.05-0.45, P = 0.01) and positive prediction rate (24.5 to 32.3%).
Conclusions:
Of 3 arterial stiffness- related hemodynamic parameters, only PWV is independently associated with progressive CKD. PWV may be a potential intervention target to mitigate risk of CKD progression and also a biomarker to improve risk-stratification of adverse renal outcome in individuals with type 2 diabetes.
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