title: Association of arterial rigidity with incident kidney disease and kidney function decline: the Health ABC study.
abstract: OBJECTIVE
  The association of large arterial rigidity and kidney function decline in longitudinal analyses is not well established. This study evaluated the association of aortic pulse wave velocity (aPWV) and pulse pressure (PP) with rapid kidney function decline and incident CKD in the Health, Aging and Body Composition study.
  
  
  METHODS
  Participants were 2129 older adults with a baseline measurement of aPWV, PP, and cystatin C and at least one additional measurement of cystatin C, either at year 3 or year 10. Outcomes were rapid kidney function decline (estimated GFRcysC loss of >3 ml/min per 1.73 m(2) per year) and incident CKD (eGFRcysC < 60 ml/min per 1.73 m(2) in participants with baseline estimated GFR > 60 ml/min per 1.73 m(2)). Multivariate regression models were used to evaluate association of aPWV and PP with each outcome.
  
  
  RESULTS
  Mean (SD) baseline estimated GFRcysC was 79±29 ml/min per 1.73 m(2). Median follow-up duration was 8.9 years. In multivariable analyses, aPWV was not associated with rapid decline (odds ratio [OR], 95% confidence interval [CI] 1.16, 0.89-1.52) but was associated with incident CKD (incident rate ratio [IRR], 95% CI, 1.39, 1.09-1.77) and PP was associated with both rapid decline (OR, 95% CI 1.10, 1.04-1.16) and incident CKD (IRR, 95% CI, 1.06, 1.01-1.11).
  
  
  CONCLUSIONS
  Large arterial stiffness assessed by aPWV and pulsatility assessed by PP were associated with incident CKD among older adults. Pulsatility assessed by PP was associated with rapid kidney function decline and incident CKD. Future research should determine whether interventions targeting arterial rigidity will prevent CKD development and progression.
authors.affiliation: Department of Medicine, Division of Nephrology, National Heart Institute, México City, Mexico. madero.magdalena@gmail.com
authors.forename: Magdalena
authors.initials: M
authors.lastname: Madero
authors.forename: Carmen
authors.initials: C
authors.lastname: Peralta
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Robert
authors.initials: R
authors.lastname: Canada
authors.forename: Linda
authors.initials: L
authors.lastname: Fried
authors.forename: Samer
authors.initials: S
authors.lastname: Najjar
authors.forename: Michael
authors.initials: M
authors.lastname: Shlipak
authors.forename: Eleanor
authors.initials: E
authors.lastname: Simonsick
authors.forename: Edward
authors.initials: E
authors.lastname: Lakatta
authors.forename: Kushang
authors.initials: K
authors.lastname: Patel
authors.forename: Dena
authors.initials: D
authors.lastname: Rifkin
authors.forename: Marquis
authors.initials: M
authors.lastname: Hawkins
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
authors.forename: Mark
authors.initials: M
authors.lastname: Sarnak
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C