title: Aortic stiffness and kidney disease in an elderly population.
abstract: OBJECTIVE
  The causes of chronic kidney disease (CKD) in older people are not well understood. Aortic stiffness increases with age and results in the transmission of increased pulsatility into the kidney microvasculature, potentially contributing to CKD in older populations.
  
  
  METHODS
  We utilized data from the Age, Gene/Environment, Susceptibility-Reykjavik Study, a community-based prospective cohort study of cardiovascular disease (CVD) in Iceland. The relationship of carotid pulse pressure (CPP) and carotid-femoral pulse wave velocity (CFPWV) with estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and urine albumin-creatinine ratio (ACR) was assessed using linear regression, adjusting for demographics and CVD risk factors.
  
  
  RESULTS
  940 participants (mean (SD) age 75.8 (4.7) years, mean (SD) CFPWV 12.9 (4.2) m/s, mean (SD) CPP 69 (21) mm Hg, mean (SD) eGFR 68 (16) ml/min/1.73 m(2), and median (IQR) ACR 3 (2-6) mg/g) were included in this study. At CPP greater than 85 mm Hg, a higher CPP was associated with a lower eGFR in unadjusted analyses but not after adjustment. CPP was significantly associated with a higher ACR in fully adjusted models (β (95% CI) = 0.14 (0.03, 0.24) ln mg/g per SD). Higher CFPWV was associated with lower eGFR and higher ACR in unadjusted analyses but not after adjustment.
  
  
  CONCLUSIONS
  Greater aortic stiffness may be associated with modestly higher levels of albuminuria in the elderly. The association between aortic stiffness and lower eGFR may be confounded by age and CVD risk factors.
authors.affiliation: Division of Nephrology, Tufts Medical Center, Boston, Mass., USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Michener
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.forename: Farzad
authors.initials: F
authors.lastname: Noubary
authors.forename: Naya
authors.initials: N
authors.lastname: Huang
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.forename: Margret B
authors.initials: MB
authors.lastname: Andresdottir
authors.forename: Runolfur
authors.initials: R
authors.lastname: Palsson
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Levey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology* / Q000652:urine; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002339:Carotid Arteries; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood / Q000652:urine; D055316:Cystatin C / Q000097:blood; D005260:Female; D005263:Femoral Artery; D005919:Glomerular Filtration Rate; D006801:Humans; D007055:Iceland; D016014:Linear Models; D008297:Male; D055806:Microvessels; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012079:Renal Circulation; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D059289:Vascular Stiffness
chemical_list: D055316:Cystatin C; D003404:Creatinine