Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
Universidade Federal do Espirito Santo, Vitoria, ES - Brasil.
Arq Bras Cardiol. 2024 Mar 4;120(12):e20230409. doi: 10.36660/abc.20230409. eCollection 2024.
Central Illustration : Higher Arterial Stiffness Predicts Chronic Kidney Disease in Adults: The ELSA-Brasil Cohort Study.
Arterial stiffening can directly affect the kidneys, which are passively perfused by a high flow. However, whether the relation between arterial stiffness and renal function depends on diabetes and hypertension conditions, is a matter of debate.
To investigate the relationship between arterial stiffening by carotid-to-femoral pulse wave velocity (cfPWV) and chronic kidney disease (CKD) incidence in individuals and verify whether this association is present in individuals without hypertension and diabetes.
A longitudinal study of 11,647 participants of the ELSA-Brasil followed up for four years (2008/10-2012/14). Baseline cfPWV was grouped per quartile, according to sex-specific cut-offs. Presence of CKD was ascertained by glomerular filtration rate (eGFR-CKD-EPI) < 60 ml/min/1.73 m2 and/or albumin-to-creatinine ratio ≥ 30 mg/g. Logistic regression models were run for the whole cohort and a subsample free from hypertension and diabetes at baseline, after adjustment for age, sex, race, schooling, smoking, cholesterol/HDL ratio, body mass index, diabetes, use of antihypertensive, systolic blood pressure, heart rate, and cardiovascular disease. Statistical significance was set at 5%.
The chance of CKD was 42% (CI 95%: 1.05;1.92) greater among individuals in the upper quartile of cfPWV. Among normotensive, non-diabetic participants, individuals in the 2nd, 3rd, and 4th quartiles of cfPWV presented greater chances of developing CKD, as compared to those in the lower quartile, and the magnitude of this association was the greatest for those in the upper quartile (OR: 1.81 CI 95%: 1.14;2.86).
Higher cfPWV increased the chances of CKD and suggests that this effect is even greater in individuals without diabetes and hypertension.
中心图：颈动脉-股动脉脉搏波速度升高预示成年人慢性肾脏病：ELSA-Brasil 队列研究。
动脉僵硬度可直接影响肾脏，肾脏由高流量被动灌注。然而，动脉僵硬与肾功能之间的关系是否取决于糖尿病和高血压的情况，仍存在争议。
探讨颈动脉-股动脉脉搏波速度（cfPWV）与个体慢性肾脏病（CKD）发生率之间的关系，并验证在无高血压和糖尿病的个体中是否存在这种相关性。
对巴西 ELSA 队列的 11647 名参与者进行了一项纵向研究，随访时间为 4 年（2008/10-2012/14 年）。根据性别特异性截断值，按 quartile 分组，将基线 cfPWV 分组。通过肾小球滤过率（eGFR-CKD-EPI）<60ml/min/1.73m2和/或白蛋白/肌酐比值≥30mg/g 确定 CKD 存在。在整个队列和基线时无高血压和糖尿病的亚组中，使用 logistic 回归模型进行调整，调整因素包括年龄、性别、种族、教育程度、吸烟、胆固醇/高密度脂蛋白比值、体重指数、糖尿病、使用抗高血压药物、收缩压、心率和心血管疾病。统计学意义设定为 5%。
cfPWV 处于较高四分位数的个体发生 CKD 的几率为 42%（95%CI：1.05；1.92）。在血压正常、无糖尿病的参与者中，cfPWV 处于第 2、3 和 4 四分位数的个体发生 CKD 的几率高于第 1 四分位数，且 cfPWV 处于较高四分位数的个体这种相关性的程度最大（OR：1.81，95%CI：1.14；2.86）。
较高的 cfPWV 增加了 CKD 的发生几率，提示在无糖尿病和高血压的个体中，这种影响更大。
