title: Arterial stiffness evaluated by carotid-femoral pulse wave velocity increases the risk of chronic kidney disease in a Chinese population-based cohort.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Although pulse wave velocity (PWV), which reflects arterial stiffness, was increased in subjects with CKD, little is known regarding whether arterial stiffness can increase the risk of CKD. To help clarify this we conducted a prospective cohort study to measure the association of arterial stiffness with CKD.
  
  
  METHODS
  A total of 7154 adults aged 54.8 ± 10.6 years undergoing physical examinations without CKD at baseline were enrolled. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cfPWV). CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min per 1.73 m2) or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method.
  
  
  RESULTS
  During 3 years of follow-up, 167 (2.3%) patients developed CKD, 101 (1.4%) patients with proteinuria and 68 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, either cfPWV (per 1 m/s increase) or the highest quartile of cfPWV (increased cfPWV) was independently associated with increased risk of proteinuria, with a fully adjusted OR of 1.15 (95% CI, 1.07 to 1.23) and 1.93 (95% CI, 1.15 to 3.25), respectively. By contrast, neither cfPWV (per 1 m/s increase) nor increased cfPWV was associated with decreased eGFR in the multivariable logistic regression analysis.
  
  
  CONCLUSIONS
  The study revealed that arterial stiffness increases the risk of proteinuria. This suggests that vascular stiffness could be considered as a target for delaying the development of CKD.
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Xianglei
authors.initials: X
authors.lastname: Kong
authors.affiliation: Department of Health Examination Center, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Zunsong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Meiyu
authors.initials: M
authors.lastname: Cui
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D002339:Carotid Arteries; D002681:China; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000503:physiopathology*; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*
keywords: arterial stiffness; chronic kidney disease; estimated glomerular filtration rate; proteinuria; pulse wave velocity