Arterial stiffness and declines in individuals with normal renal function/early chronic kidney disease

作者：Tomiyama Hirofumi; Tanaka Hirofumi; Hashimoto Hideki; Matsumoto Chisa; Odaira Mari; Yamada Jiko; Yoshida Masanobu; Shiina Kazuki; Nagata Mikio; Yamashina Akira^*

来源：Atherosclerosis, 2010, 212(1): 345-350.

DOI：10.1016/j.atherosclerosis.2010.05.033

• Arterial stiffness
• Renal function
• Arteriosclerosis
• Kidney
• Inflammation

Objective: We evaluated the temporal association between arterial stiffening and the early stage of renal functional decline.
Methods: In 2053 Japanese employees with an estimated glomerular filtration rate (GFR) of >= 60 ml/min/1.73m(2) plus no proteinuria (40 +/- 8 years old) at the start, brachial-ankle pulse wave velocity (baPWV) and serum C-reactive protein (CRP) were measured before and after a 5-6-year follow-up period.
Results: After adjusting for confounding variables including serum CRP levels, higher baseline baPWV was associated with lower follow-up GFR (value expressed as per doubling: -16; 95% confidence interval: -24 to -9; P < 0. 01) and with higher annual rate of decline in GFR (value expressed as per doubling: -3; 95% confidence interval: -4 to -2; P < 0.01). Every m/s higher baPWV was associated with a 36% increased odds (95% CI 1.09-1.70; P < 0.01) for a development of a GFR < 60 ml/min/1.73m(2) at follow-up. In contrast, baseline GFR was not associated with follow-up baPWV (P = 0.08) or the annual rate of change in baPWV (P = 0.11).
Conclusion: In a Japanese occupational cohort with normal renal function/early chronic kidney disease, elevated arterial stiffness was an independent risk factor for the decline in renal function. CRP did not appear to exert any significant influence on this association.

• 出版日期2010-9