Aortic PWV in chronic kidney disease: a CRIC ancillary study.
BACKGROUND
Aortic pulse wave velocity (PWV) is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end-stage renal disease receiving hemodialysis. Little data exist characterizing aortic stiffness in patients with chronic kidney disease (CKD) who are not receiving dialysis, and in particular the effect of reduced kidney function on aortic PWV.


METHODS
We performed measurements of aortic PWV in a cross-sectional cohort of participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased aortic PWV in CKD.


RESULTS
PWV measurements were obtained in 2,564 participants. The tertiles of aortic PWV (adjusted for waist circumference) were <7.7 m/s, 7.7-10.2 m/s, and >10.2 m/s with an overall mean (+/- s.d.) value of 9.48 +/- 3.03 m/s (95% confidence interval = 9.35-9.61 m/s). Multivariable regression identified significant independent positive associations of age, blood glucose concentrations, race, waist circumference, mean arterial blood pressure, gender, and presence of diabetes with aortic PWV and a significant negative association with the level of kidney function.


CONCLUSIONS
The large size of this unique cohort, and the targeted enrollment of CKD participants provides an ideal situation to study the role of reduced kidney function as a determinant of arterial stiffness. Arterial stiffness may be a significant component of the enhanced cardiovascular risk associated with kidney failure.
Townsend
Raymond R
RR
Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. townsend@mail.med.upenn.edu
Wimmer
Neil J
NJ
Chirinos
Julio A
JA
Parsa
Afshin
A
Weir
Matthew
M
Perumal
Kalyani
K
Lash
James P
JP
Chen
Jing
J
Steigerwalt
Susan P
SP
Flack
John
J
Go
Alan S
AS
Rafey
Mohammed
M
Rahman
Mahboob
M
Sheridan
Angela
A
Gadegbeku
Crystal A
CA
Robinson
Nancy A
NA
Joffe
Marshall
M
D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D011674:Pulse; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*; D014481:United States / Q000453:epidemiology; D014655:Vascular Resistance