Estimated pulse wave velocity and incident chronic kidney disease: evidence from a prospective cohort and...

This study aims to investigate the association between estimated pulse wave velocity (ePWV) and risk of incident chronic kidney disease (CKD).

A total of 3,240 participants aged ≥45 years without baseline CKD were included. Additionally, a meta-analysis of 18 studies involving 209,970 participants was conducted. ePWV was calculated using age and mean arterial pressure, with participants categorized into tertiles: lower (<8.36 m/s), medium (8.36-9.91 m/s), and higher (≥9.92 m/s). Incident CKD was defined as physician-diagnosed CKD or estimated glomerular filtration rate <60 mL/min/1.73 m2 based on cystatin C.

During a median follow-up of 9.0 years, 494 participants (15.2 %) developed CKD. After adjusting for potential confounders, compared with the lower-ePWV group, the hazard ratios for CKD were 1.26 (95 % CI, 0.96-1.66) in the medium-ePWV group and 1.53 (95 % CI, 1.07-2.17) in the higher-ePWV group. Each standard deviation increase in ePWV was associated with a 42 % higher risk (HR = 1.42; 95 % CI, 1.23-1.63). Meta-analysis confirmed this association (pooled HR = 1.58; 95 % CI, 1.36-1.83) with evidence of a nonlinear dose-response relationship.

Higher ePWV was independently associated with increased risk of incident CKD. These findings suggest that ePWV may serve as a valuable tool for early CKD risk stratification in clinical practice.