title: Brachial-ankle pulse wave velocity and rate of renal function decline and mortality in chronic kidney disease.
abstract: OBJECTIVE
  Increased arterial stiffness was reported to be associated with decreased estimated GFR (eGFR). Previous studies suggested that arterial stiffness might play a role in renal function progression in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether there was an independent association between brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, and renal function progression in CKD patients.
  
  
  METHODS
  This longitudinal study enrolled 145 patients with CKD stages 3 to 5. The baPWV was measured by using an ABI-form device. The change in renal function was estimated by eGFR slope. The study endpoints were defined as commencement of dialysis or death.
  
  
  RESULTS
  After a stepwise multivariate analysis, the eGFR slope was positively associated with baseline eGFR and negatively associated with hypertension and baPWV (β=-0.165, P=0.033). Seventeen patients entering dialysis, and eight deaths were recorded. Multivariate forward Cox regression analysis identified that higher baPWV (hazard ratio, 1.001; P=0.001), lower baseline eGFR, and higher serum phosphate level were independently associated with progression to commencement of dialysis or death.
  
  
  CONCLUSIONS
  Our results show an independent association between baPWV and renal function decline and progression to commencement of dialysis or death in patients with CKD. Screening CKD patients by means of baPWV may help identify a high-risk group of rapid renal function decline and progression to commencing dialysis or death.
authors: Division of Nephrology, Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Szu-Chia
authors: SC
authors: Chen
authors: Jer-Ming
authors: JM
authors: Chang
authors: Wan-Chun
authors: WC
authors: Liu
authors: Yi-Chun
authors: YC
authors: Tsai
authors: Jer-Chia
authors: JC
authors: Tsai
authors: Po-Chao
authors: PC
authors: Hsu
authors: Tsung-Hsien
authors: TH
authors: Lin
authors: Ming-Yen
authors: MY
authors: Lin
authors: Ho-Ming
authors: HM
authors: Su
authors: Shang-Jyh
authors: SJ
authors: Hwang
authors: Hung-Chun
authors: HC
authors: Chen
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011673:Pulsatile Flow