Department of Internal Medicine, Seoul National University Postgraduate School, Seoul, Korea.
Department of Internal Medicine, Eulji University, Eulji General Hospital, Seoul, Korea.
Sci Rep. 2018 Jan 16;8(1):821. doi: 10.1038/s41598-018-19334-w.
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 m/year was defined as rapid decline. During a mean of 2.2 years, the mean eGFR change was -3.6 ml/min/1.73 m/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.
肱踝脉搏波速度（baPWV）和心-股脉搏波速度（hfPWV）对估算肾小球滤过率（eGFR）快速下降的影响尚无定论。我们对 2011 年至 2016 年期间韩国一项多中心前瞻性研究的 2238 例患者的数据库进行了回顾。排除 baPWV 缺失（n=257）和 eGFR 变化（n=180）的患者后，研究纳入了 1801 例非透析慢性肾脏病（CKD）患者。eGFR 变化＜-5ml/min/1.73m/year 定义为快速下降。在平均 2.2 年的随访期间，平均 eGFR 变化为-3.6ml/min/1.73m/year，31.6%的患者被归类为快速下降。年龄较大、CKD 病因、心率增加、收缩压升高和蛋白尿与最高 baPWV 五分位组相关。在多变量逻辑回归分析中，第 5 五分位组的 eGFR 快速下降的可能性是第 1 五分位组的 1.9 倍（P=0.013）。在 baPWV 和 hfPWV 亚组（n=1182）中，仅当 baPWV 高时伴有 hfPWV 高时，baPWV 才与快速 eGFR 下降相关。这些发现表明，中心和外周脉搏波速度可能同时影响快速 eGFR 下降。
