Arterial stiffness and declines in individuals with normal renal function/early chronic kidney disease.
OBJECTIVE
We evaluated the temporal association between arterial stiffening and the early stage of renal functional decline.


METHODS
In 2053 Japanese employees with an estimated glomerular filtration rate (GFR) of > or = 60 ml/min/1.73 m(2) plus no proteinuria (40+/-8 years old) at the start, brachial-ankle pulse wave velocity (baPWV) and serum C-reactive protein (CRP) were measured before and after a 5-6-year follow-up period.


RESULTS
After adjusting for confounding variables including serum CRP levels, higher baseline baPWV was associated with lower follow-up GFR (value expressed as per doubling: -16; 95% confidence interval: -24 to -9; P<0.01) and with higher annual rate of decline in GFR (value expressed as per doubling: -3; 95% confidence interval: -4 to -2; P<0.01). Every m/s higher baPWV was associated with a 36% increased odds (95% CI 1.09-1.70; P<0.01) for a development of a GFR <60 ml/min/1.73 m(2) at follow-up. In contrast, baseline GFR was not associated with follow-up baPWV (P=0.08) or the annual rate of change in baPWV (P=0.11).


CONCLUSIONS
In a Japanese occupational cohort with normal renal function/early chronic kidney disease, elevated arterial stiffness was an independent risk factor for the decline in renal function. CRP did not appear to exert any significant influence on this association.
Tomiyama
Hirofumi
H
Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan.
Tanaka
Hirofumi
H
Hashimoto
Hideki
H
Matsumoto
Chisa
C
Odaira
Mari
M
Yamada
Jiko
J
Yoshida
Masanobu
M
Shiina
Kazuki
K
Nagata
Mikio
M
Yamashina
Akira
A
D000328:Adult; D055109:Ankle Brachial Index; D001158:Arteries / Q000503:physiopathology*; D001161:Arteriosclerosis / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D018450:Disease Progression; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000453:epidemiology / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D002097:C-Reactive Protein