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BMC Nephrology
Published in: BMC Nephrology 1/2020

Open Access 01-12-2020 | Chronic Kidney Disease | Research article

Aortic pulse wave velocity, central pulse pressure, augmentation index and chronic kidney disease progression in individuals with type 2 diabetes: a 3- year prospective study

Authors: Jian-Jun Liu, Sylvia Liu, Janus Lee, Resham L. Gurung, M. Yiamunaa, Keven Ang, Yi Ming Shao, Robin W. M. Choo, Subramaniam Tavintharan, Wern Ee Tang, Chee Fang Sum, Su Chi Lim

Published in: BMC Nephrology | Issue 1/2020

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Abstract

Background

Pulse wave velocity (PWV), central pulse pressure and augmentation index are arterial stiffness- related hemodynamic parameters but their associations with renal outcome are still controversial. We hereby aim to study, 1) which hemodynamic parameter is independently associated with progressive chronic kidney disease (CKD), 2) the association of 3-year change in PWV with CKD progression and, 3) the additive predictive value of PWV for progressive CKD.

Methods

Carotid- femoral PWV, central pulse pressure and augmentation index were measured in 1444 participants with type 2 diabetes at baseline and 3 years apart. Progressive CKD was defined as confirmed eGFR decline 40% or greater.

Results

In the follow-up, 102 participants experienced progressive CKD. All 3 hemodynamic parameters were significantly associated with progressive CKD In univariable analysis. However, only PWV remained statistically significant after adjustment for known clinical risk factors and the other 2 hemodynamic parameters (OR 1.14 [95% CI 1.01–1.29] per m/s increment). One m/s regression (decrement) in PWV in the 3-year follow-up was associated with 26% lower adjusted- risk of progressive CKD (OR 0.74, 95% CI 0.56–0.97). Adding PWV onto traditional risk factor- based model significantly improved classification (net reclassification improvement 0.25, 95% CI 0.05–0.45, P = 0.01) and positive prediction rate (24.5 to 32.3%).

Conclusions

Of 3 arterial stiffness- related hemodynamic parameters, only PWV is independently associated with progressive CKD. PWV may be a potential intervention target to mitigate risk of CKD progression and also a biomarker to improve risk-stratification of adverse renal outcome in individuals with type 2 diabetes.
Appendix
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Metadata
Title
Aortic pulse wave velocity, central pulse pressure, augmentation index and chronic kidney disease progression in individuals with type 2 diabetes: a 3- year prospective study
Authors
Jian-Jun Liu
Sylvia Liu
Janus Lee
Resham L. Gurung
M. Yiamunaa
Keven Ang
Yi Ming Shao
Robin W. M. Choo
Subramaniam Tavintharan
Wern Ee Tang
Chee Fang Sum
Su Chi Lim
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2020
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-020-02024-z

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