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Association of arterial rigidity with incident kidney disease and kidney function decline: the Health ABC study.
Clin J Am Soc Nephrol 2013; 8(3):424-33CJ

Abstract

BACKGROUND AND 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.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

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+Show Affiliations

Department of Medicine, Division of Nephrology, National Heart Institute, México City, Mexico. madero.magdalena@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23271800

Citation

Madero, Magdalena, et al. "Association of Arterial Rigidity With Incident Kidney Disease and Kidney Function Decline: the Health ABC Study." Clinical Journal of the American Society of Nephrology : CJASN, vol. 8, no. 3, 2013, pp. 424-33.
Madero M, Peralta C, Katz R, et al. Association of arterial rigidity with incident kidney disease and kidney function decline: the Health ABC study. Clin J Am Soc Nephrol. 2013;8(3):424-33.
Madero, M., Peralta, C., Katz, R., Canada, R., Fried, L., Najjar, S., ... Sarnak, M. (2013). Association of arterial rigidity with incident kidney disease and kidney function decline: the Health ABC study. Clinical Journal of the American Society of Nephrology : CJASN, 8(3), pp. 424-33. doi:10.2215/CJN.07900812.
Madero M, et al. Association of Arterial Rigidity With Incident Kidney Disease and Kidney Function Decline: the Health ABC Study. Clin J Am Soc Nephrol. 2013;8(3):424-33. PubMed PMID: 23271800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of arterial rigidity with incident kidney disease and kidney function decline: the Health ABC study. AU - Madero,Magdalena, AU - Peralta,Carmen, AU - Katz,Ronit, AU - Canada,Robert, AU - Fried,Linda, AU - Najjar,Samer, AU - Shlipak,Michael, AU - Simonsick,Eleanor, AU - Lakatta,Edward, AU - Patel,Kushang, AU - Rifkin,Dena, AU - Hawkins,Marquis, AU - Newman,Anne, AU - Sarnak,Mark, AU - ,, Y1 - 2012/12/27/ PY - 2012/12/29/entrez PY - 2012/12/29/pubmed PY - 2013/8/27/medline SP - 424 EP - 33 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 8 IS - 3 N2 - BACKGROUND AND 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. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: 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. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/23271800/Association_of_arterial_rigidity_with_incident_kidney_disease_and_kidney_function_decline:_the_Health_ABC_study_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=23271800 DB - PRIME DP - Unbound Medicine ER -