Department of Cardiology, Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, 100034, China.
Int Urol Nephrol. 2021 Dec;53(12):2549-2555. doi: 10.1007/s11255-020-02776-5. Epub 2021 Jan 12.
An increase in arterial stiffness is associated with rapid renal function decline (RFD) in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether the radial augmentation index (rAI), a surrogate marker of arterial stiffness, affects RFD in individuals without CKD.
A total of 3165 Chinese participants from an atherosclerosis cohort with estimated glomerular filtration rates (eGFR) of ≥ 60 mL/min/1.73 m were included in this study. The baseline rAI normalized to a heart rate of 75 beats/min (rAIp75) was obtained using an arterial applanation tonometry probe. The eGFRs at both baseline and follow-up were calculated using the equation derived from the Chronic Kidney Disease Epidemiology Collaboration. The association of the rAIp75 with RFD (defined as a drop in the eGFR category accompanied by a ≥ 25% drop in eGFR from baseline or a sustained decline in eGFR of > 5 mL/min/1.73 m/year) was evaluated using the multivariate regression model.
During the 2.35-year follow-up, the incidence of RFD was 7.30%. The rAIp75 had no statistically independent association with RFD after adjustment for possible confounders (adjusted odds ratio = 1.12, 95% confidence interval: 0.99-1.27, p = 0.074). When stratified according to sex, the rAIp75 was significantly associated with RFD in women, but not in men (adjusted odds ratio and 95% confidence interval: 1.23[1.06-1.43], p = 0.007 for women, 0.94[0.76-1.16], p = 0.542 for men; p for interaction = 0.038).
The rAI might help screen for those at high risk of early rapid RFD in women without CKD.
动脉僵硬度的增加与慢性肾脏病（CKD）患者的肾功能快速下降（RFD）有关。本研究旨在探讨桡动脉增强指数（rAI），一种动脉僵硬度的替代标志物，是否会影响无 CKD 个体的 RFD。
本研究共纳入了一个动脉粥样硬化队列中的 3165 名中国参与者，他们的估计肾小球滤过率（eGFR）≥60 mL/min/1.73 m。使用动脉平面张力探头获得了基础心率为 75 次/分时标准化的 rAI（rAIp75）。使用来源于慢性肾脏病流行病学合作研究的方程计算了基线和随访时的 eGFR。使用多变量回归模型评估了 rAIp75 与 RFD（定义为 eGFR 类别下降，同时 eGFR 较基线下降≥25%或 eGFR 持续下降>5 mL/min/1.73 m/年）之间的关联。
在 2.35 年的随访期间，RFD 的发生率为 7.30%。在调整了可能的混杂因素后，rAIp75 与 RFD 没有统计学上的独立相关性（调整后的优势比=1.12，95%置信区间：0.99-1.27，p=0.074）。按性别分层时，rAIp75 与女性的 RFD 显著相关，但与男性无关（调整后的优势比和 95%置信区间：1.23[1.06-1.43]，p=0.007 女性，0.94[0.76-1.16]，p=0.542 男性；p 交互=0.038）。
rAI 可能有助于筛选出无 CKD 女性中早期快速 RFD 风险较高的人群。
