Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

Abstract

ObjectiveBoth decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women.MethodsIn this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties.ResultsThe mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75.ConclusionsIn Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

Subclinical Renal Insufficiency Range of Estimated Glomerular Filtration Rate and Microalbuminuria Are Independently Associated with Increased Arterial Stiffness in Never Treated Hypertensives

“…Our results indicate that arterial stiffening is independently associated with minimally reduced eGFR and MAU. These results agree with previous studies of high risk patients with moderate or severe renal dysfunction patients 8-10). However, our results are important because patients with more than moderate renal dysfunction as assessed by eGFR values of <60 mL/min/1.73 m 2 were excluded and we assessed the independent impact of MAU and eGFR on arterial stiffness.…”

“…Bian's study showed that carotid-femoral PWV and Augmentation index increased on going from the top to the bottom eGFR tertile in Chinese women with normal kidney function 8). Astor et al11) also noted that both lower eGFR and MAU increased CV mortality, but they compared moderately decreased eGFR (eGFR <60 mL/1.73 m 2 ) with normal eGFR (>90 mL/1.73 m 2 ).…”

“…Many reports find increased risk of CVD when eGFR is less than 60 mL/1.73 m 2 , but few studies have investigated arterial stiffness in minimally reduced eGFR (60≤eGFR<90 mL/1.73 m 2 ) 8-11). Bian's study showed that carotid-femoral PWV and Augmentation index increased on going from the top to the bottom eGFR tertile in Chinese women with normal kidney function 8).…”

Pulse wave velocity and neutrophil gelatinase-associated lipocalin as predictors of acute kidney injury following aortic valve replacement

“…As renal perfusion and subsequent kidney function may also be affected by abnormal blood flow patterns, in chronic kidney disease (CKD), non-invasive markers such as aortic stiffness have also been used as predictive and prognostic markers of renal function [ 10 , 11 ]. There is limited evidence to link aortic stiffness with renal function in non-kidney disease patients [ 12 - 14 ], and its role after cardiac surgery is yet to be investigated. However, preliminary data does suggest that elevated arterial stiffness may be an early predictor of renal function decline in the general population [ 12 , 13 ].…”

Serum Osteopontin Level Correlates with Carotid-Femoral Pulse Wave Velocity in Geriatric Persons

“…There is evidence that cfPWV increases as GFR falls [ 29 ]. Decreased GFR exhibited a significant reverse association with cfPWV in women with normal to mildly impaired renal function [ 30 ]. Coronary artery disease patients with impaired renal function had greater cfPWV compared to those with coronary artery disease patients and normal renal function [ 31 ].…”