title: Brachial-ankle pulse wave velocity and brachial pre-ejection period to ejection time ratio with renal outcomes in chronic kidney disease.
abstract: Heart failure and increased arterial stiffness are associated with declining renal function. This longitudinal study was designed to assess whether the combination of brachial-ankle pulse wave velocity (baPWV) and the ratio of brachial pre-ejection period (bPEP) to brachial ejection time (bET) was independently associated with renal outcomes in patients with chronic kidney disease (CKD), stages 3-5. The baPWV and bPEP/bET values were measured using an ankle-brachial index (ABI)-form device in 186 patients who were classified into 4 groups according to the baPWV and bPEP/bET median values. Renal function change was determined by estimated glomerular filtration rate (eGFR) slope. Rapid renal progression was defined as an eGFR slope less than -3 ml min(-1) per 1.73 m(2) per year. The renal endpoints were defined as commencement of dialysis or 25% decline in eGFR. Among the four study groups, the group with high baPWV and bPEP/bET values had the lowest eGFR slope (P0.042). Multivariate analysis revealed that this group was independently associated with rapid renal progression (odds ratio, 9.560; P=0.009) and progression to renal endpoints (hazard ratio, 2.587; P=0.039). Our findings show that a combination of high baPWV and bPEP/bET is associated with adverse renal outcomes in patients with advanced CKD. Screening CKD patients by baPWV and bPEP/bET during the same examination may help identify patients with an elevated risk for adverse renal outcomes.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Tsai
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001916:Brachial Artery / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*