title: Arterial Stiffness and Decline in Kidney Function.
abstract: OBJECTIVE
  The independent link between arterial stiffness and CKD remains unknown. We investigated the association of indicators of arterial stiffness with decline in kidney function.
  
  
  METHODS
  We studied 3666 participants (mean age =65 years old; 58% women) from the Rotterdam Study. Pulse pressure (PP), carotid stiffness, and pulse wave velocity (PWV) were measured. We created genetic risk scores for PP and PWV. Annual declines in kidney function and incident CKD were assessed using eGFR. To put our findings in context of the literature, we performed a meta-analysis of the available population-based studies.
  
  
  RESULTS
  After a median (interquartile range) follow-up time of 11 (10.7-11.3) years, 601 participants with incident CKD were recognized. In the model adjusted for age, sex, mean arterial pressure, heart rate, and baseline GFR, each SD higher PP was associated with 0.15-ml/min per 1.73 m(2) steeper annual eGFR decline (95% confidence interval [95% CI], 0.10 to 0.20) and 11% higher risk of incident CKD (95% CI, 1.05 to 1.18). Each SD greater carotid stiffness was associated with 0.08-ml/min per 1.73 m(2) steeper annual eGFR decline (95% CI, 0.04 to 0.13) and 13% higher risk of incident CKD (95% CI, 1.05 to 1.22). Each SD higher PWV was associated with 7% higher risk of incident CKD (95% CI, 1.00 to 1.14). Incorporating our findings in a meta-analysis, each SD higher PP and PWV were associated with 16% (95% CI, 1.12 to 1.21) and 8% (95% CI, 1.03 to 1.14) higher risks of incident CKD. Each SD higher PP genetic risk score was associated with 0.06-ml/min per 1.73 m(2) steeper annual eGFR decline (95% CI, 0.01 to 0.10) and 8% higher risk of incident CKD (95% CI, 1.03 to 1.14). There was no association between PWV genetic risk score and kidney function decline.
  
  
  CONCLUSIONS
  Higher indices of arterial stiffness are associated with steeper decline in kidney function. This suggests that vascular stiffness could be considered as a target for delaying decline in kidney function.
authors.affiliation: Departments of Epidemiology.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sedaghat
authors.affiliation: Internal Medicine-Geriatric Medicine.
authors.forename: Francesco U S
authors.initials: FU
authors.lastname: Mattace-Raso
authors.affiliation: Internal Medicine-Nephrology and Transplantation.
authors.forename: Ewout J
authors.initials: EJ
authors.lastname: Hoorn
authors.affiliation: Internal Medicine.
authors.forename: Andre G
authors.initials: AG
authors.lastname: Uitterlinden
authors.affiliation: Departments of Epidemiology.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Departments of Epidemiology, Radiology, and Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Departments of Epidemiology.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Departments of Epidemiology, a.dehghan@erasmusmc.nl.
authors.forename: Abbas
authors.initials: A
authors.lastname: Dehghan
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D013997:Time Factors; D059289:Vascular Stiffness / Q000235:genetics
keywords: arterial stiffness; blood pressure; carotid stiffness; chronic kidney disease; follow-up studies; genetic risk score; meta-analysis; pulse pressure; pulse wave analysis; vascular stiffness