Utilising pulse wave velocity in assessing arterial stiffness in patients with mild-to-moderate chronic kidney disease

Abstract

Introduction: Arterial damage in patients with chronic kidney disease (CKD) is characterized by increased arterial stiffness, which is associated with increased cardiovascular risk, particularly seen in elderly patients with advanced CKD. However, arterial stiffness among the young early CKD is not clear. The study investigates the presence of arterial stiffness using pulse wave velocity (PWV) in the younger-age adults with stages 2 to 4 CKD. Methods: Eighty-seven patients with stages 2-4 CKD and eighty-seven control subjects with normal renal function participated in the study. Demographic details, comorbidities, risk factors, medications as well as blood samples were collected. Arterial stiffness was determined using carotid-femoral PWV  Results: The mean age for CKD patients was 47+5.4 years. CKD patients had a higher mean PWV (7.8+1.7 m/s) compared to control subjects (5.6+1.0 m/s) (p<0.001, 95% CI -2.59-1.77). A significant difference in mean PWV was also found between patients with stage 2 CKD (7.6+1.5 m/s) and control subjects (5.6+1.0 m/s) (p<0.001, 95% CI -2.40, -1.49). A stepwise increase in PWV corresponding to CKD stages was observed (p<0.001). Furthermore, significant differences were seen in mean PWV in CKD patients with diabetes (8.2+1.8 m/s) compared to non-diabetic CKD patients (7.3 + 1.3 m/s) (p=0.022, 95% CI -1.50, -0.12). Multiple linear regression analysis revealed pulse pressure as an independent predictor of abnormal PWV (r2=0.249, p<0.001). Conclusion: In summary, arterial stiffness occurs early in younger CKD stage 2 patients. Increased arterial stiffness occurs in parallel with a decline in glomerular filtration rate in patients with mild-to-moderate CKD.