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Updated: Oct 15, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Kidney Function and Aortic Stiffness, Pulsatility, and Endothelial Function in African Americans: The Jackson Heart
Harsha S Nagarajarao1, Solomon K Musani2, Keith E Cobb3
1Department of Medicine, Texas Tech University of Health Sciences, El Paso, TX.
Insights
Increased arterial stiffness and pulsatility are linked to reduced kidney function in African Americans. This highlights a potential target for kidney disease prevention in this population.
Area of Science:
- Cardiovascular Health
- Nephrology
- Vascular Biology
Background:
- The relationship between vascular stiffness, endothelial function, and kidney function is not well understood in African Americans.
- This study investigates these connections within this specific demographic.
Purpose of the Study:
- To test the hypothesis that increased vascular stiffness and endothelial dysfunction are associated with reduced estimated glomerular filtration rate (eGFR) and albuminuria in African Americans.
- To explore the association between hemodynamic parameters and kidney function markers.
Main Methods:
- Cross-sectional cohort analysis of 2,244 participants from the Jackson Heart Study (2012-2017).
- Noninvasive hemodynamic assessment including carotid-femoral pulse wave velocity and forward wave amplitude.
- Logistic and linear regression models were used to analyze the risk for chronic kidney disease.
Main Results:
- Higher carotid-femoral pulse wave velocity was associated with reduced eGFR (OR, 1.37) and prevalent albuminuria (OR, 1.66).
- Increased forward wave amplitude was significantly associated with prevalent albuminuria (OR, 1.37).
- Reduced eGFR and elevated urinary albumin-creatinine ratio were present in 10.4% of participants.
Conclusions:
- Higher arterial stiffness and pulsatility correlate with increased odds of reduced eGFR in African Americans.
- While causality cannot be determined from this cross-sectional study, findings suggest arterial stiffness as a potential factor in kidney disease progression.
- Future research should examine if interventions targeting arterial stiffness can protect kidney function in African Americans.
Rationale & Objective:
The relation of vascular stiffness, endothelial function, and kidney function is incompletely elucidated in African Americans. Our hypothesis was that increased vascular stiffness and endothelial dysfunction are associated with low estimated glomerular filtration rate (eGFR) and albuminuria in African Americans.
Study Design:
Cross-sectional cohort analysis of data from the Jackson Heart Study.
Settings & Patients:
2,244 Jackson Heart Study participants (2012-2017 after Exam 3) who had undergone noninvasive hemodynamic assessment using arterial tonometry.
Predictors:
Baseline carotid-femoral pulse wave velocity, pulsatile hemodynamics forward wave amplitude, and hyperemic brachial artery flow were measured. Reduced eGFR was defined as eGFR between 15 and 60 mL/min/1.73 m2.
Outcomes:
Prevalent albuminuria, urinary albumin-creatinine ratio.
Analytical Approach:
2-sample t test for continuous variables and χ2 test for categorical variables in addition to logistic and linear regression models to assess the risk for chronic kidney disease with each proposed hemodynamic variable.
Results:
Among 2,244 participants, mean age was 66 ± 11 years and 64% were women. Reduced eGFR was present in 233 (10.4%), and elevated urinary albumin-creatinine ratio, in 232 (10.4%). In multivariable-adjusted analyses, higher carotid-femoral pulse wave velocity was associated with the presence of reduced eGFR (OR, 1.37 [95% CI, 1.08-1.75] per SD; P = 0.01) and with prevalent albuminuria (OR, 1.66 [95% CI, 1.32-2.11]; P < 0.001). Higher forward wave amplitude was significantly associated with prevalent albuminuria (OR, 1.37 [95% CI, 1.14-1.65]; P = 0.001).
Limitations:
Cross-sectional analyses cannot inform causality.
Conclusions:
Higher arterial stiffness and pulsatility are associated with higher odds of reduced eGFR in African Americans. Future studies should focus on whether improving arterial stiffness contributes to kidney protection in African Americans.
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