Inflammation and arterial stiffness in chronic kidney disease

Findings from the CRIC study

behalf of the CRIC Study Investigators

Research output: Contribution to journalArticle

Abstract

BACKGROUND Chronic kidney disease (CKD) and arterial stiffness are associated with increased cardiovascular morbidity and mortality. Inflammation is proposed to have a role in the development of arterial stiffness, and CKD is recognized as a proinflammatory state. Arterial stiffness is increased in CKD, and cross-sectional data has suggested a link between increased inflammatory markers in CKD and higher measures of arterial stiffness. However, no large scale investigations have examined the impact of inflammation on the progression of arterial stiffness in CKD. METHODS We performed baseline assessments of 5 inflammatory markers in 3,939 participants from the chronic renal insufciency cohort (CRIC), along with serial measurements of arterial stiffness at 0, 2, and 4 years of follow-up. RESULTS A total of 2,933 participants completed each of the follow-up stiffness measures. In cross-sectional analysis at enrollment, signifcant associations with at least 2 measures of stiffness were observed for fbrinogen, interleukin-6, high-sensitivity C-reactive protein, proteinuria, and composite inflammation score after adjustment for confounders. In longitudinal analyses, there were few meaningful correlations between baseline levels of inflammation and changes in metrics of arterial stiffness over time. CONCLUSION In a large cohort of CKD participants, we observed multiple signifcant correlations between initial markers of inflammation and metrics of arterial stiffness, but baseline inflmmation did not predict changes in arterial stiffness over time. While well-described biologic mechanisms provide the basis for our understanding of the cross-sectional results, continued efforts to design longitudinal studies are necessary to fully elucidate the relationship between chronic inflammation and arterial stiffening.

Original languageEnglish (US)
Pages (from-to)400-408
Number of pages9
JournalAmerican Journal of Hypertension
Volume30
Issue number4
DOIs
StatePublished - 2017

Fingerprint

Vascular Stiffness
Chronic Renal Insufficiency
Cohort Studies
Inflammation
Kidney
Arteritis
Proteinuria
C-Reactive Protein
Longitudinal Studies
Interleukin-6
Cross-Sectional Studies
Morbidity
Mortality

Keywords

  • Arterial stiffness
  • Blood pressure
  • Chronic kidney disease
  • Hypertension
  • Inflammation

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Inflammation and arterial stiffness in chronic kidney disease : Findings from the CRIC study. / behalf of the CRIC Study Investigators.

In: American Journal of Hypertension, Vol. 30, No. 4, 2017, p. 400-408.

Research output: Contribution to journalArticle

behalf of the CRIC Study Investigators. / Inflammation and arterial stiffness in chronic kidney disease : Findings from the CRIC study. In: American Journal of Hypertension. 2017 ; Vol. 30, No. 4. pp. 400-408.
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abstract = "BACKGROUND Chronic kidney disease (CKD) and arterial stiffness are associated with increased cardiovascular morbidity and mortality. Inflammation is proposed to have a role in the development of arterial stiffness, and CKD is recognized as a proinflammatory state. Arterial stiffness is increased in CKD, and cross-sectional data has suggested a link between increased inflammatory markers in CKD and higher measures of arterial stiffness. However, no large scale investigations have examined the impact of inflammation on the progression of arterial stiffness in CKD. METHODS We performed baseline assessments of 5 inflammatory markers in 3,939 participants from the chronic renal insufciency cohort (CRIC), along with serial measurements of arterial stiffness at 0, 2, and 4 years of follow-up. RESULTS A total of 2,933 participants completed each of the follow-up stiffness measures. In cross-sectional analysis at enrollment, signifcant associations with at least 2 measures of stiffness were observed for fbrinogen, interleukin-6, high-sensitivity C-reactive protein, proteinuria, and composite inflammation score after adjustment for confounders. In longitudinal analyses, there were few meaningful correlations between baseline levels of inflammation and changes in metrics of arterial stiffness over time. CONCLUSION In a large cohort of CKD participants, we observed multiple signifcant correlations between initial markers of inflammation and metrics of arterial stiffness, but baseline inflmmation did not predict changes in arterial stiffness over time. While well-described biologic mechanisms provide the basis for our understanding of the cross-sectional results, continued efforts to design longitudinal studies are necessary to fully elucidate the relationship between chronic inflammation and arterial stiffening.",
keywords = "Arterial stiffness, Blood pressure, Chronic kidney disease, Hypertension, Inflammation",
author = "{behalf of the CRIC Study Investigators} and Eliot Peyster and Jing Chen and Feldman, {Harold I.} and Go, {Alan S.} and Jayanta Gupta and Nandita Mitra and Qiang Pan and Anna Porter and Mahboob Rahman and Dominic Raj and Muredach Reilly and Wing, {Maria R.} and Wei Yang and Townsend, {Raymond R.} and Lawrence Appel and Jiang He and Wright, {Jackson T.} and Lash, {James P.} and John Kusek",
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T1 - Inflammation and arterial stiffness in chronic kidney disease

T2 - Findings from the CRIC study

AU - behalf of the CRIC Study Investigators

AU - Peyster, Eliot

AU - Chen, Jing

AU - Feldman, Harold I.

AU - Go, Alan S.

AU - Gupta, Jayanta

AU - Mitra, Nandita

AU - Pan, Qiang

AU - Porter, Anna

AU - Rahman, Mahboob

AU - Raj, Dominic

AU - Reilly, Muredach

AU - Wing, Maria R.

AU - Yang, Wei

AU - Townsend, Raymond R.

AU - Appel, Lawrence

AU - He, Jiang

AU - Wright, Jackson T.

AU - Lash, James P.

AU - Kusek, John

PY - 2017

Y1 - 2017

N2 - BACKGROUND Chronic kidney disease (CKD) and arterial stiffness are associated with increased cardiovascular morbidity and mortality. Inflammation is proposed to have a role in the development of arterial stiffness, and CKD is recognized as a proinflammatory state. Arterial stiffness is increased in CKD, and cross-sectional data has suggested a link between increased inflammatory markers in CKD and higher measures of arterial stiffness. However, no large scale investigations have examined the impact of inflammation on the progression of arterial stiffness in CKD. METHODS We performed baseline assessments of 5 inflammatory markers in 3,939 participants from the chronic renal insufciency cohort (CRIC), along with serial measurements of arterial stiffness at 0, 2, and 4 years of follow-up. RESULTS A total of 2,933 participants completed each of the follow-up stiffness measures. In cross-sectional analysis at enrollment, signifcant associations with at least 2 measures of stiffness were observed for fbrinogen, interleukin-6, high-sensitivity C-reactive protein, proteinuria, and composite inflammation score after adjustment for confounders. In longitudinal analyses, there were few meaningful correlations between baseline levels of inflammation and changes in metrics of arterial stiffness over time. CONCLUSION In a large cohort of CKD participants, we observed multiple signifcant correlations between initial markers of inflammation and metrics of arterial stiffness, but baseline inflmmation did not predict changes in arterial stiffness over time. While well-described biologic mechanisms provide the basis for our understanding of the cross-sectional results, continued efforts to design longitudinal studies are necessary to fully elucidate the relationship between chronic inflammation and arterial stiffening.

AB - BACKGROUND Chronic kidney disease (CKD) and arterial stiffness are associated with increased cardiovascular morbidity and mortality. Inflammation is proposed to have a role in the development of arterial stiffness, and CKD is recognized as a proinflammatory state. Arterial stiffness is increased in CKD, and cross-sectional data has suggested a link between increased inflammatory markers in CKD and higher measures of arterial stiffness. However, no large scale investigations have examined the impact of inflammation on the progression of arterial stiffness in CKD. METHODS We performed baseline assessments of 5 inflammatory markers in 3,939 participants from the chronic renal insufciency cohort (CRIC), along with serial measurements of arterial stiffness at 0, 2, and 4 years of follow-up. RESULTS A total of 2,933 participants completed each of the follow-up stiffness measures. In cross-sectional analysis at enrollment, signifcant associations with at least 2 measures of stiffness were observed for fbrinogen, interleukin-6, high-sensitivity C-reactive protein, proteinuria, and composite inflammation score after adjustment for confounders. In longitudinal analyses, there were few meaningful correlations between baseline levels of inflammation and changes in metrics of arterial stiffness over time. CONCLUSION In a large cohort of CKD participants, we observed multiple signifcant correlations between initial markers of inflammation and metrics of arterial stiffness, but baseline inflmmation did not predict changes in arterial stiffness over time. While well-described biologic mechanisms provide the basis for our understanding of the cross-sectional results, continued efforts to design longitudinal studies are necessary to fully elucidate the relationship between chronic inflammation and arterial stiffening.

KW - Arterial stiffness

KW - Blood pressure

KW - Chronic kidney disease

KW - Hypertension

KW - Inflammation

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