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Sci Rep. 2018;8(1):821.

Relationship between brachial-ankle and heart-femoral pulse wave velocities and the rapid decline of kidney function.

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제1저자 이성우 · 교신저자 오국환

PMID 29339822 PMC5770427 DOI 10.1038/s41598-018-19334-w IF 4.9 신장내과
소속 (9)
  1. Department of Internal Medicine, Seoul National University Postgraduate School, Seoul, Korea.
  2. Department of Internal Medicine, Eulji University, Eulji General Hospital, Seoul, Korea.
  3. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  4. Department of Internal Medicine, Gachon University, Gil Hospital, Incheon, Korea.
  5. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
  6. Cancer Research Institute, Seoul National University, Seoul, Korea.
  7. Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.
  8. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  9. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. ohchris@hanmail.net.

Abstract

The impact of brachial-ankle pulse wave velocity (baPWV) and heart-femoral pulse wave velocity (hfPWV) on rapid decline of estimated glomerular filtration rate (eGFR) has been inconclusive. The database of a multicenter prospective study of 2238 patients in Korea enrolled from 2011 to 2016 was reviewed. After excluding patients with missing baPWV (n = 257) and eGFR change (n = 180), the study included 1801 non-dialysis chronic kidney disease (CKD) patients. The eGFR change <-5ml/min/1.73 m2/year was defined as rapid decline. During a mean of 2.2 years, the mean eGFR change was -3.6 ml/min/1.73 m2/year, and 31.6% of patients were classified as having rapid decline. Older age, causes of CKD, increased heart rate, systolic blood pressures, and proteinuria were associated with the highest baPWV quintile. In multivariate logistic regression analyses, the odds of a rapid decline in eGFR was 1.9 times higher in the fifth quintile than in the first quintile (P = 0.013). In a subset with baPWV and hfPWV (n = 1182), high baPWV was associated with rapid eGFR decline only when accompanied by a high hfPWV. These findings suggest that central and peripheral PWVs may simultaneously affect rapid eGFR decline.

Figures

Figure 1
Figure 1 Scatter plot of the relationship between baPWV and changes in the eGFR. baPWV, brachial-ankle pulse wave velocity; eGFR, estimated glomerular filtration rate. The red line represents the regression line.
Figure 2
Figure 2 Risk for the rapid decline in the eGFR according to the status of the baPWV. baPWV, brachial-ankle pulse wave velocity; eGFR, estimated glomerular filtration rate; OR, odds ratio; CI, confidence interval. *P < 0.05 when compared with the 1Q of baPWV. The adjusted OR and its CI were calculated using a multivariate logistic regression analysis, into which age, sex, smoking pack-year, beta blocker use, diabetes, causes of chronic kidney diseases, heart rate, pulse pressure, serum levels of calcium and phosphorus, eGFR, bilirubin, albumin, cholesterol, hemoglobin, and logarithm of urine protein-to-creatinine ratio were entered.
Figure 3
Figure 3 Penalized smoothing splines showing the relationship between the baPWV and the rapid decline in the eGFR. baPWV, brachial-ankle pulse wave velocity; eGFR, estimated glomerular filtration rate. OR, odds ratio; CI, confidence interval. The upper and lower 2.5% of the baPWV were truncated. The red line indicates the OR and the black dotted line indicates the 95% CI for which baPWV influences the rapid decline in the eGFR. In the multivariate analysis, the covariates were age, sex, smoking pack-year, beta blocker use, diabetes, causes of chronic kidney diseases, heart rate, pulse pressure, serum levels of calcium and phosphorus, eGFR, bilirubin, albumin, cholesterol, hemoglobin, and logarithm of urine protein-to-creatinine ratio.
Figure 4
Figure 4 Subgroup analysis for the OR of both high baPWV and hfPWV (High-ba/High-hf) vs. both low baPWV and hfPWV (Low-ba/Low-hf) for a rapid eGFR decline. baPWV, brachial-ankle pulse wave velocity; hfPWV, heart-femoral pulse wave velocity; OR, odds ratio; CI, confidence interval; CKD, chronic kidney disease; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; PP, pulse pressure. OR and its 95% CI were calculated using multivariate logistic analysis, entering into age, sex, diabetes, causes of CKD, PP, eGFR, logarithm of urine protein-to-creatinine ratio, albumin, cholesterol, hemoglobin, serum calcium level, and beta blocker use as covariates. When one covariate was chosen as a subgroup, it was omitted from the model.

그림 출처: PubMed Central 공개 논문 (PMC5770427)

Conflict of interest statement

The authors declare that they have no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2018-01-16
MeSH
Adult · Aged · Brachial Artery* · Chronic Disease · Disease Progression · Female · Femoral Artery* · Glomerular Filtration Rate · Humans · Kidney Diseases / pathology · Korea · Male · Middle Aged · Prospective Studies · Pulse Wave Analysis*
참고문헌
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