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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

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Predictive ability of arterial stiffness parameters for renal function decline: a retrospective cohort study

Daiji Nagayama1,2, Kentaro Fujishiro3, Toru Miyoshi4

  • 1Department of Internal Medicine, Nagayama Clinic, Tochigi.

Journal of Hypertension
|June 15, 2022
PubMed

Insights

Cardio-ankle vascular index (CAVI) best predicts renal function decline in the general population. Higher CAVI indicates increased risk, suggesting it may be a modifiable factor for preventing kidney disease.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Public Health

Background:

  • Arterial stiffness is increasingly recognized as a contributor to cardiovascular and renal disease.
  • The predictive value of different arterial stiffness parameters for renal function decline is not fully understood.
  • Assessing arterial stiffness may offer insights into early detection and prevention of kidney disease.

Purpose of the Study:

  • To compare the predictive ability of three arterial stiffness parameters for renal function decline in a Japanese general population.
  • To evaluate cardio-ankle vascular index (CAVI), heart-ankle pulse wave velocity (haPWV), and CAVI 0 for predicting decline in kidney function.
  • To identify the most effective arterial stiffness parameter for assessing renal function decline risk.

Main Methods:

  • A large cohort of 27,864 Japanese urban residents without baseline renal impairment was studied.
  • Participants underwent 2–8 consecutive annual health examinations.
  • Renal function decline was defined as estimated glomerular filtration rate <60 ml/min per 1.73 m².

Main Results:

  • 6.6% of participants developed renal function decline, all with high arterial stiffness values.
  • Receiver-operating characteristic analysis showed CAVI had the highest discriminatory power (C-statistic: 0.740) compared to haPWV (0.734) and CAVI 0 (0.726).
  • Cox-proportional hazards analysis indicated that CAVI significantly predicted renal function decline, with restricted cubic spline analysis confirming CAVI's superior reflection of risk.

Conclusions:

  • Increased arterial stiffness, particularly CAVI, is a significant risk factor for renal function decline in the general population.
  • CAVI may serve as a key modifiable risk factor for preventing chronic kidney disease.
  • Further research into CAVI-lowering interventions is warranted to prevent kidney disease progression.
Abstract

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