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. 2015;41(4-5):320-8.
doi: 10.1159/000431332. Epub 2015 Jun 6.

Aortic stiffness and kidney disease in an elderly population

Katherine H Michener  1 , Gary F Mitchell, Farzad Noubary, Naya Huang, Tamara Harris, Margret B Andresdottir, Runolfur Palsson, Vilmundur Gudnason, Andrew S Levey
Affiliations

Aortic stiffness and kidney disease in an elderly population

Katherine H Michener et al. Am J Nephrol. 2015.

Abstract

Background/aims: The causes of chronic kidney disease (CKD) in older people are not well understood. Aortic stiffness increases with age and results in the transmission of increased pulsatility into the kidney microvasculature, potentially contributing to CKD in older populations.

Methods: We utilized data from the Age, Gene/Environment, Susceptibility-Reykjavik Study, a community-based prospective cohort study of cardiovascular disease (CVD) in Iceland. The relationship of carotid pulse pressure (CPP) and carotid-femoral pulse wave velocity (CFPWV) with estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and urine albumin-creatinine ratio (ACR) was assessed using linear regression, adjusting for demographics and CVD risk factors.

Results: 940 participants (mean (SD) age 75.8 (4.7) years, mean (SD) CFPWV 12.9 (4.2) m/s, mean (SD) CPP 69 (21) mm Hg, mean (SD) eGFR 68 (16) ml/min/1.73 m(2), and median (IQR) ACR 3 (2-6) mg/g) were included in this study. At CPP greater than 85 mm Hg, a higher CPP was associated with a lower eGFR in unadjusted analyses but not after adjustment. CPP was significantly associated with a higher ACR in fully adjusted models (β (95% CI) = 0.14 (0.03, 0.24) ln mg/g per SD). Higher CFPWV was associated with lower eGFR and higher ACR in unadjusted analyses but not after adjustment.

Conclusion: Greater aortic stiffness may be associated with modestly higher levels of albuminuria in the elderly. The association between aortic stiffness and lower eGFR may be confounded by age and CVD risk factors.

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Conflict of interest statement

Conflict of Interest:

Gary Mitchell is owner of Cardiovascular Engineering, Inc., a company that develops and manufactures devices to measure vascular stiffness, serves as a consultant to and receives honoraria from Novartis and Merck, and is funded by research grants from the National Institutes of Health.

Andrew S. Levey reports funding to Tufts Medical Center for research and contracts with the National Institutes of Health, National Kidney Foundation, Amgen, Pharmalink AB and Gilead Sciences, and a patent pending for novel metabolites to estimate GFR. Provisional patent [Coresh, Inker and Levey] was filed 8/15/2014: Precise estimation of glomerular filtration rate from multiple biomarkers (licensing under negotiations).

Tamara Harris works for the National Institute on Aging (NIA).

Margret B Andresdottir, Vilmundur Gudnason, Runolfur Palsson, Farzad Noubary, Naya Huang and Katherine Michener have none to declare.

Figures

Figure 1
Figure 1. Relationship of aortic stiffness with kidney measures
Top left: relationship of iCFPWV on eGFR. Top right: relationship of iCFPWV on ACR. Bottom left: relationship of CPP on eGFR. Bottom right: relationship of CPP on ACR. Abbreviations: iCFPWV, inverse carotid femoral pulse wave velocity; eGFR, estimated glomerular filtration rate; ACR, urine albumin to creatinine ratio; CPP, carotid pulse pressure.
See this image and copyright information in PMC

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