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. 2020 Sep 30:7:588967.
doi: 10.3389/fmed.2020.588967. eCollection 2020.

Peripheral Arterial Stiffness Increases the Risk of Progression of Renal Disease in Type 2 Diabetic Patients

Tae Hoon Lim  1 , Seung Min Chung  2 , Dong Sung Lee  1 , Se Ra Choi  1 , Jun Sung Moon  2 , Ji Sung Yoon  2 , Kyu Chang Won  2 , Hyoung Woo Lee  2
Affiliations

Peripheral Arterial Stiffness Increases the Risk of Progression of Renal Disease in Type 2 Diabetic Patients

Tae Hoon Lim et al. Front Med (Lausanne). .

Abstract

Aims: Our aim was to investigate the effects of peripheral arterial stiffness on the risk of progression of renal disease in patients with type 2 diabetes (T2D). Methods: This was a single center, retrospective cohort study. Brachial-ankle pulse wave velocity (baPWV) tests were performed on T2D patients in 2015. Increased arterial stiffness was defined as baPWV of ≥ 1800 cm/s. We applied criteria for progression of renal disease according to EMPA-REG OUTCOME trial. Results: In total, 186 patients were enrolled in the final study. The mean age was 59.1 years and male:female ratio was 1.73:1. Thirteen (7%) patients progressed to renal disease during the average follow-up time of 35.3 months. In particular, the risk of progression to macroalbuminuria was significantly higher in the baPWV ≥ 1800 cm/s group (HR 6.216, p = 0.020). Individuals with a baPWV of ≥ 1800 cm/s (when comparisons were adjusted for age, sex, blood pressure, diabetes duration, eGFR, and use of renin-angiotensin system inhibitors) had a significantly higher risk of the progression of renal disease (HR = 8.480, p = 0.014). Conclusion: These results suggest that peripheral arterial stiffness (baPWV ≥ 1800 cm/s) may be a risk factor for the progression of renal disease in T2D patients.

Keywords: arterial stiffness; diabetes mellitus; diabetic nephropathy; pulse wave velocity; renal function decline.

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Figures

Figure 1
Figure 1
Scatter plot of the relationship between baPWV and (A) baseline eGFR and (B) annual changes in eGFR. The red line represents the regression line.
Figure 2
Figure 2
Risk of peripheral arterial stiffness (baPWV ≥ 1800 cm/s) on (A) progression to macroalbuminuria (uACR > 300 mg) and (B) progression of renal disease. A log-rank (Mantel-Cox) survival analysis was used.
See this image and copyright information in PMC

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