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Arterial Stiffness and Acute Kidney Injury in the Atherosclerosis Risk in Communities (ARIC) Study
Ester S Oh1, Aditya L Surapaneni2, Jessica B Kendrick1
1Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO.
Kidney Medicine
|November 10, 2025
Summary
Higher arterial stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), may predict acute kidney injury (AKI) risk in older adults. Increased cfPWV was independently associated with AKI, suggesting its potential as a novel predictor.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Geriatrics
Background:
- Acute kidney injury (AKI) presents a significant challenge due to inaccurate prediction and high mortality risk.
- Arterial stiffness, a marker of cardiovascular health, is increasingly recognized for its association with organ function decline.
Purpose of the Study:
- To investigate whether higher baseline carotid-femoral pulse wave velocity (cfPWV) independently predicts AKI risk in community-dwelling older adults.
- To explore arterial stiffness as a potential novel predictor for AKI.
Main Methods:
- An observational cohort study of 4,245 older adults from the Atherosclerosis Risk in Communities study.
- Carotid-femoral pulse wave velocity (cfPWV) was the primary predictor, analyzed using Cox proportional hazard models in quartiles.
- AKI was defined by International Classification of Diseases (ICD) codes.
Main Results:
- A J-shaped association was observed between cfPWV and AKI risk.
- Participants in the highest quartile of cfPWV had a 1.38-fold increased risk of AKI (HR 1.38 [1.08-1.77]) compared to the reference quartile, after full adjustment.
- The association remained significant after accounting for demographics, cardiovascular risk factors, and kidney/peripheral artery disease markers.
Conclusions:
- Elevated arterial stiffness, quantified by cfPWV, is independently associated with an increased risk of developing AKI in older adults.
- cfPWV may serve as a valuable predictor for identifying individuals at higher risk of AKI.
- Further research could explore interventions targeting arterial stiffness to mitigate AKI risk.
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