Cardio-ankle vascular index with renal progression and mortality in high atherosclerosis risk: a prospective cohort

Related Experiment Video

Updated: Sep 21, 2026

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

Noppawit Aiumtrakul1, Ouppatham Supasyndh2, Rungroj Krittayaphong3

  • 1Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. noppawit.aiumtrakul@gmail.com.

Clinical and Experimental Nephrology
|October 13, 2021
PubMed

Insights

Increased arterial stiffness, measured by high cardio-ankle vascular index (CAVI), significantly elevates the risk of worsening kidney function and mortality in high-risk Thai individuals. This finding highlights CAVI as a crucial indicator for renal and overall health outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Vascular Biology

Background:

  • Arterial stiffness is a known indicator of endothelial dysfunction and associated with cardiovascular diseases.
  • Limited research exists on the impact of arterial stiffness on the progression of kidney disease.

Purpose of the Study:

  • To investigate the association between high cardio-ankle vascular index (CAVI) and renal outcomes, as well as all-cause mortality.
  • To assess these associations in a Thai population characterized by high risk of atherosclerosis.

Main Methods:

  • A multicenter prospective cohort study involving 4898 high-risk individuals in Thailand.
  • Participants were categorized into three groups based on mean CAVI: <8, 8-8.9, and ≥9.
  • Primary composite renal outcome included eGFR decline >40%, eGFR <15 mL/min/1.73 m², doubled serum creatinine, dialysis initiation, or renal death. Secondary outcomes included all-cause mortality, CV mortality, and eGFR decline.

Main Results:

  • High CAVI (≥9) was significantly associated with an increased risk of the primary composite renal outcome (1.45-fold) and all-cause mortality (1.72-fold) compared to normal CAVI (<8).
  • After multivariate analysis, high CAVI remained positively associated only with the primary composite renal outcome.
  • Kaplan-Meier survival analysis indicated the poorest survival rates for the primary composite outcome and all-cause mortality in the high CAVI group.

Conclusions:

  • Elevated arterial stiffness, indicated by high CAVI, is a significant risk factor for kidney function decline and end-stage renal disease in a high-atherosclerosis-risk Thai population.
  • CAVI serves as a valuable predictor for renal disease progression and mortality in this demographic.
Abstract

Keywords:
Cardio-ankle vascular indexDialysisEnd-stage renal diseaseGlomerular filtration rateHigh cardiovascular riskMortality

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