Arterial Stiffness as a Risk Factor for Subclinical Coronary Artery Calcification in Predialysis Chronic Kidney Disease: From the KNOW-CKD Study

Hyun, Young Youl; Kim, Hyang; Oh, Kook Hwan; Ahn, Curie; Park, Sung Sup; Chae, Dong Wan; Han, Seung Hyeok; Kim, Yong Soo; Lee, Sung Woo; Kim, Chang Seong; Lee, Kyu Beck

doi:10.1159/000499648

Cited by 11 publications

(4 citation statements)

References 33 publications

(36 reference statements)

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“…There was a gradual and independent association between low eGFR and CAC at the study entry in the KNOW-CKD subjects [21]. In view of arterial stiffness measured by PWV, the subjects with higher baPWV (brachial-ankle PWV) exhibited higher prevalence of CAC, suggesting that increased arterial stiffness is independently associated with CAC [22].…”

Section: Coronary Artery Calcificationmentioning

confidence: 90%

The KNOW-CKD Study: What we have learned about chronic kidney diseases

Kang

et al. 2020

Kidney Res Clin Pract

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Chronic kidney disease (CKD) is a growing health burden worldwide, as well as in Korea [1]. The numbers of patients with CKD and end-stage renal disease (ESRD) are increasing rapidly [2,3]. Not only CKD is a significant factor in morbidity and mortality, but the medical expenses for management of CKD are increasing remarkably.In order to broaden knowledge regarding the risk factors for CKD progression and adverse outcomes, the KoreaN Cohort Study for Outcomes in Patients With

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Section: Coronary Artery Calcificationmentioning

confidence: 90%

The KNOW-CKD Study: What we have learned about chronic kidney diseases

Kang

et al. 2020

Kidney Res Clin Pract

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“…Several studies have evaluated the role of arterial stiffness and renal function in various populations with varying results. Our results demonstrated significant change in GFR with vascular stiffness among patients with overall high CV risk with baseline GFR at 54 mL/min/1.73 m 3 . This was consistent with related clinical studies, in which aortic stiffness is shown to be independently associated with progressive renal impairment among patients with advanced Advance Publication Journal of Atherosclerosis and Thrombosis Accepted for publication: September 10, 2019 Published online: October 10, 2019 ever, in our multivariate logistic regression analyses, increased vascular stiffness or CAVI was significantly associated with a faster decrease in GFR, independent of age and sex.…”

Section: Discussionmentioning

confidence: 51%

“…Increased arterial stiffness remains a major risk factor for cardiovascular (CV) diseases, and it is useful to estimate the degree of arteriosclerosis by examining arterial stiffness to prevent CV events 1) . Arterial stiffness and peripheral vascular disease are also particularly common complications of chronic kidney disease (CKD) and are related to volume expansion, uncontrolled hypertension, and vascular calcification among patients with CKD [2][3][4] . Therefore, risk factors of arterial disease and stiffness are implicated in the association between CV disease and kidney disease 5) .…”

Section: Introductionmentioning

confidence: 99%

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Satirapoj

Triwatana

Supasyndh

2020

JAT

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Arterial stiffness is known to be an important surrogate marker for atherosclerosis and predictor of peripheral vascular and cardiovascular (CV) disease. Whether high cardio-ankle vascular index (CAVI) is associated with the development of rapid glomerular filtration rate (GFR) decline remains uncertain. The study aimed to determine the relationship between CAVI and renal function progression among patients with high CV risk. Methods: This study employed a prospective cohort design with 1-year follow-up among patients with high CV risk. Arterial stiffness was measured using CAVI method. GFR was estimated using the chronic kidney disease (CKD) epidemiology collaboration equation, and rapid decline in GFR was defined with decrease in GFR ≥ 5 mL/min/1.73 m 2 yearly. Results: Of 352 patients with mean age 67.8 10.1 years, 224 patients (63.6%) were suspected to have arteriosclerosis (CAVI ≥ 9), and 208 patients (59.1%) had CKD (GFR 60 mL/min/1.73 m 2). Annual decline of GFR was −0.75 [interquartile range (IQR), −1.16 to 6.08] mL/min/1.73 m 2 /year, and 30.1% of patients experienced a rapid decline in GFR. Compared with normal CAVI (CAVI 8), high CAVI (CAVI ≥ 9) and borderline CAVI (CAVI 8-8.9) in all subjects and subgroup of baseline GFR 60 mL/min/1.73 m 2 were associated with rapid GFR decline. Multivariable analysis showed that high CAVI and borderline CAVI were associated with 2.47-fold (95% CI, 0.89-6.84; P 0.082) and 4.04-fold (95% CI, 1.46-11.18; P 0.007) increased odds ratio of rapid GFR decline, respectively. Conclusion: Among patients with high risk of CV with or without CKD, high CAVI (cut point of ≥ 9) was independently associated with a rapid decline in GFR, suggesting that systemic vascular stiffness predicted a decrease in renal function in this population. ness of vessels potentially leads to microvascular ischemia and tissue damage including renal microvascular supply 6). Arterial stiffening causes increased systolic blood pressure and pulse pressure. Both factors might be associated with rapid decline in glomerular filtration rate (GFR) 7). Related clinical studies have indicated an independent association between arterial stiffness and decline in renal function, but the results were inconsistent, differing in study populations, environments, and confounding factors 8-11). The association between arterial stiffness and renal progression remains to be established. Cardio-ankle vascular index (CAVI) Copyright©2019 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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“…12 Moreover, an increase in central pulse pressure (cPP) to levels greater than 50 mmHg is associated with worsening renal function and increased adverse CV outcomes. [12][13][14] Finally, vascular calci cation is commonly found in patients with advanced-stage CKD. 15 These patients present phenotypic changes that culminate in homeostatic disturbances of calcium, phosphorus, parathormone (PTH), and calcitriol, in addition to disorders relating to bone metabolism and remodeling, with increased resorption and heterotopic calci cation, especially vascular calci cation.…”

Section: Introductionmentioning

confidence: 99%

Osteoprotegerin and Vascular Dysfunction in Patients With Stage 3 Chronic Kidney Disease and Those Without Renal Dysfunction: a Case-control Study (Nefrovasc Study)

Matos,

Vitorino,

Orlow

et al. 2023

Preprint

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Background: Osteoprotegerin (OPG) is a marker of vascular calcification and cardiovascular (CV) risk in patients with chronic kidney disease (CKD). The study aimed to compare OPG values with flow-mediated dilation (FMD) and pulse wave velocity (PWV) and to evaluate the correlation between these measures in patients in stage 3 CKD and those without renal dysfunction. Methods: This case-control study was conducted in a specialized hypertension clinic in 2022. A total of 79 patients over 18 years of age participated in the study. The case group consisted of 30 patients who had moderate renal dysfunction (CKD stage 3a and 3b) and the control group included 49 individuals with GFR ≥60 ml/min/1.73 m2. For the comparative analysis between patients with and without renal dysfunction, qualitative variables were analyzed using the chi-square test, while quantitative variables were evaluated using the independent t-test or Mann-Whitney test. The linear correlation between OPG and the other variables was analyzed using Pearson's or Spearman's correlation tests. Results: Central pulse pressure (cPP), PWV, and augmentation index (AIx) were higher in patients with renal dysfunction. The serum OPG level positively correlated with peripheral and central systolic blood pressure (BP), PPc, PWV, and AIx. Conversely, the serum OPG did not correlate with FMD. Conclusions: OPG and PWV are possible biomarkers of vascular dysfunction that are altered in patients with moderate renal dysfunction. This study is has limitations: is a case-control study conducted at a single center with a small number of patients with CKD.

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Arterial Stiffness as a Risk Factor for Subclinical Coronary Artery Calcification in Predialysis Chronic Kidney Disease: From the KNOW-CKD Study

Cited by 11 publications

References 33 publications

The KNOW-CKD Study: What we have learned about chronic kidney diseases

The KNOW-CKD Study: What we have learned about chronic kidney diseases

Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks

Osteoprotegerin and Vascular Dysfunction in Patients With Stage 3 Chronic Kidney Disease and Those Without Renal Dysfunction: a Case-control Study (Nefrovasc Study)

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