Association of arterial rigidity with incident kidney disease and kidney function decline: The health ABC study

Magdalena Madero, Carmen Peralta, Ronit Katz, Robert Canada, Linda Fried, Samer Najjar, Michael Shlipak, Eleanor Marie Simonsick, Edward Lakatta, Kushang Patel, Dena Rifkin, Marquis Hawkins, Anne Newman, Mark Sarnak

Research output: Contribution to journalArticle

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 m2 per year) and incident CKD (eGFRcysC <60 ml/min per 1.73 m2 in participants with baseline estimated GFR > 60 ml/min per 1.73 m2). 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 m2. 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.

Original languageEnglish (US)
Pages (from-to)424-433
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume8
Issue number3
DOIs
StatePublished - Mar 7 2013
Externally publishedYes

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Kidney Diseases
Pulse Wave Analysis
Blood Pressure
Kidney
Health
Confidence Intervals
Cystatin C
Odds Ratio
Vascular Stiffness
Body Composition

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Association of arterial rigidity with incident kidney disease and kidney function decline : The health ABC study. / Madero, Magdalena; Peralta, Carmen; Katz, Ronit; Canada, Robert; Fried, Linda; Najjar, Samer; Shlipak, Michael; Simonsick, Eleanor Marie; Lakatta, Edward; Patel, Kushang; Rifkin, Dena; Hawkins, Marquis; Newman, Anne; Sarnak, Mark.

In: Clinical Journal of the American Society of Nephrology, Vol. 8, No. 3, 07.03.2013, p. 424-433.

Research output: Contribution to journalArticle

Madero, M, Peralta, C, Katz, R, Canada, R, Fried, L, Najjar, S, Shlipak, M, Simonsick, EM, Lakatta, E, Patel, K, Rifkin, D, Hawkins, M, Newman, A & 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, vol. 8, no. 3, pp. 424-433. https://doi.org/10.2215/CJN.07900812
Madero, Magdalena ; Peralta, Carmen ; Katz, Ronit ; Canada, Robert ; Fried, Linda ; Najjar, Samer ; Shlipak, Michael ; Simonsick, Eleanor Marie ; Lakatta, Edward ; Patel, Kushang ; Rifkin, Dena ; Hawkins, Marquis ; Newman, Anne ; Sarnak, Mark. / Association of arterial rigidity with incident kidney disease and kidney function decline : The health ABC study. In: Clinical Journal of the American Society of Nephrology. 2013 ; Vol. 8, No. 3. pp. 424-433.
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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 m2 per year) and incident CKD (eGFRcysC <60 ml/min per 1.73 m2 in participants with baseline estimated GFR > 60 ml/min per 1.73 m2). 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 m2. 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.",
author = "Magdalena Madero and Carmen Peralta and Ronit Katz and Robert Canada and Linda Fried and Samer Najjar and Michael Shlipak and Simonsick, {Eleanor Marie} and Edward Lakatta and Kushang Patel and Dena Rifkin and Marquis Hawkins and Anne Newman and Mark Sarnak",
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T1 - Association of arterial rigidity with incident kidney disease and kidney function decline

T2 - 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 Marie

AU - Lakatta, Edward

AU - Patel, Kushang

AU - Rifkin, Dena

AU - Hawkins, Marquis

AU - Newman, Anne

AU - Sarnak, Mark

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Y1 - 2013/3/7

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 m2 per year) and incident CKD (eGFRcysC <60 ml/min per 1.73 m2 in participants with baseline estimated GFR > 60 ml/min per 1.73 m2). 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 m2. 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.

AB - 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 m2 per year) and incident CKD (eGFRcysC <60 ml/min per 1.73 m2 in participants with baseline estimated GFR > 60 ml/min per 1.73 m2). 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 m2. 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.

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