title: Inflammation and Arterial Stiffness in Chronic Kidney Disease: Findings From the CRIC Study.
abstract: BACKGROUND
  Chronic kidney disease (CKD) and arterial stiffness are associated with increased cardiovascular morbidity and mortality. Inflammation is proposed to have a role in the development of arterial stiffness, and CKD is recognized as a proinflammatory state. Arterial stiffness is increased in CKD, and cross-sectional data has suggested a link between increased inflammatory markers in CKD and higher measures of arterial stiffness. However, no large scale investigations have examined the impact of inflammation on the progression of arterial stiffness in CKD.
  
  
  METHODS
  We performed baseline assessments of 5 inflammatory markers in 3,939 participants from the chronic renal insufficiency cohort (CRIC), along with serial measurements of arterial stiffness at 0, 2, and 4 years of follow-up.
  
  
  RESULTS
  A total of 2,933 participants completed each of the follow-up stiffness measures. In cross-sectional analysis at enrollment, significant associations with at least 2 measures of stiffness were observed for fibrinogen, interleukin-6, high-sensitivity C-reactive protein, proteinuria, and composite inflammation score after adjustment for confounders. In longitudinal analyses, there were few meaningful correlations between baseline levels of inflammation and changes in metrics of arterial stiffness over time.
  
  
  CONCLUSIONS
  In a large cohort of CKD participants, we observed multiple significant correlations between initial markers of inflammation and metrics of arterial stiffness, but baseline inflammation did not predict changes in arterial stiffness over time. While well-described biologic mechanisms provide the basis for our understanding of the cross-sectional results, continued efforts to design longitudinal studies are necessary to fully elucidate the relationship between chronic inflammation and arterial stiffening.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Eliot
authors.initials: E
authors.lastname: Peyster
authors.affiliation: Tulane University Schools of Medicine and Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.|Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Harold I
authors.initials: HI
authors.lastname: Feldman
authors.affiliation: Division of Research, Kaiser Permanente of Northern California, Oakland, California, USA.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
authors.affiliation: Department of Health Sciences, College of Health Professions and Social Work, Florida Gulf Coast University, Fort Myers, Florida, USA.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Gupta
authors.affiliation: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
authors.affiliation: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Department of Medicine, University of Illinois, Chicago, Illinois, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Porter
authors.affiliation: Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Mahboob
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Division of Renal Diseases & Hypertension, MFA-George Washington University, Washington, DC, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Raj
authors.affiliation: Irving Institute for Clinical and Translational Research, Columbia University, New York, New York, USA.
authors.forename: Muredach
authors.initials: M
authors.lastname: Reilly
authors.affiliation: Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Wing
authors.affiliation: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Townsend
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000276:immunology; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000276:immunology; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000276:immunology; D053583:Interleukin-1beta / Q000276:immunology; D015850:Interleukin-6 / Q000276:immunology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D016212:Transforming Growth Factor beta / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D059289:Vascular Stiffness / Q000276:immunology*
chemical_list: C508585:IL1B protein, human; C507763:IL1RN protein, human; C508600:IL6 protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D015850:Interleukin-6; C439524:TNF protein, human; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: arterial stiffness; blood pressure; chronic kidney disease; hypertension; inflammation