Brachial–Ankle Pulse Wave Velocity Predicts Decline in Renal Function and Cardiovascular Events in Early Stages of Chronic Kidney Disease
Abstract
Objective: In this study, we investigated the predictive capacity of the brachial–ankle aortic pulse
wave velocity (baPWV), a marker of arterial stiffness, for the decline in renal function and for
cardiovascular events in the early stages of chronic kidney disease (CKD).
Method: Two hundred forty-one patients who underwent a comprehensive check-up were included and were divided into two groups according to their estimated glomerular filtration rates
(eGFR): patients with CKD categories G2, G3a and G3b (30 ≤ eGFR < 90 ml/min/1.73m2
, eGFR <
90 group; n=117) and those with eGFR ≥ 90 ml/min/1.73 m2 (eGFR ≥ 90 group; n=124). The
change in renal function, the eGFR change, was determined by the slope of eGFR against time. We
analysed whether baPWV was associated with eGFR change or predicted cardiovascular events.
Results: baPWV was independently associated with eGFR change in a multivariate analysis of the
total patients (β=–0.011, p=0.011) and remained significantly associated with eGFR change in a
subgroup analysis of the eGFR < 90 group (β=–0.015, p=0.035). baPWV was independently associated with cardiovascular events (odds ratio=1.002, p=0.048) in the eGFR < 90 group, but not
in the eGFR ≥ 90 group. The receiver operative characteristic curve analysis showed that 1,568
cm/sec was the cut-off value of baPWV for predicting CV events in the eGFR < 90 group (area
under curve=0.691, p=0.03)
Conclusions: In patients with early stages of CKD, baPWV was independently associated with
the decline in renal function and short-term cardiovascular events.