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Published on: June 16, 2014
Association of Arterial Stiffness with Chronic Kidney Disease: A Systematic Review
Angela L Beros1, John D Sluyter1, Robert Scragg1
1School of Population Health, University of Auckland, Auckland, New Zealand.
Insights
Arterial stiffness may predict the onset and rapid decline of chronic kidney disease (CKD). However, its role in CKD progression and whether kidney function predicts arterial stiffness requires further investigation.
Area of Science:
- Cardiovascular Health
- Nephrology
- Epidemiology
Background:
- Chronic kidney disease (CKD) often progresses undetected until significant kidney function is lost.
- Arterial stiffness is a potential risk factor for CKD, with a possible bidirectional relationship.
- Understanding the temporal link between arterial stiffness and CKD is crucial for early diagnosis and intervention.
Purpose of the Study:
- To systematically review cohort studies examining the relationship between arterial stiffness and CKD.
- To ascertain if arterial stiffness predicts the development, progression, or rapid decline of kidney function.
- To determine if reduced kidney function predicts future arterial stiffness.
Main Methods:
- A systematic review of MEDLINE and Embase databases up to October 2023.
- Included studies investigated arterial stiffness (estimated by pulse wave velocity) as a predictor of CKD.
- Qualitative summary of study characteristics and outcomes; review protocol registered with PROSPERO.
Main Results:
- Of 17 studies, 13 found arterial stiffness predicted incident CKD.
- Six of 10 studies controlling for risk factors showed a positive association.
- Arterial stiffness predicted CKD progression in 8/17 studies and rapid kidney decline in 5/8 studies; one study suggested kidney function predicts arterial stiffness.
Conclusions:
- Arterial stiffness appears to be a predictor of incident CKD and rapid kidney function decline.
- The association between arterial stiffness and CKD progression remains uncertain.
- Further longitudinal research is needed to clarify the predictive role of kidney function on arterial stiffness.
Introduction:
Significant kidney function may be lost before CKD is diagnosed. Arterial stiffness may be a risk factor for CKD and the relationship may be bi-directional. A systematic review of cohort studies was undertaken to ascertain the temporal relationship of arterial stiffness and CKD.
Methods:
MEDLINE and Embase were searched to 4 October 2023 to identify studies that investigated whether arterial stiffness, as estimated by pulse wave velocity, was predictive of the development or progression of CKD, rapid decline in kidney function, and vice versa. The characteristics and outcomes of the included studies were set out in a qualitative summary. The review protocol is registered with PROSPERO (CRD42019129563).
Results:
Forty-two studies were included, all of which were high quality with respect to bias. Thirteen of seventeen studies that investigated arterial stiffness as a predictor of incident CKD found a positive association (p < 0.05). Of the 10 studies that controlled for CKD risk factors, 6 found a positive association. Eight of seventeen studies that investigated arterial stiffness as a predictor of progression of CKD, and five out of eight studies, which investigated rapid kidney decline, found a positive association. One study of six found kidney function was able to predict future elevated arterial stiffness.
Conclusion:
Arterial stiffness may predict incident CKD and a rapid decline in CKD. It is uncertain if arterial stiffness is associated with CKD progression or whether reduced kidney function is predictive of increased arterial stiffness. Further longitudinal research is required.
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