The Cardio-Ankle Vascular Index Predicts Long-Term Kidney Prognosis in Nondiabetic CKD Patients Who Underwent Kidney Biopsy.

KEY POINTS

Cardio-Ankle Vascular Index (CAVI) is a known predictor of cardiovascular events; however, few studies have considered kidney prognosis. CAVI at the time of kidney biopsy was independently associated with long-term kidney prognosis in patients without diabetes. The CAVI cutoff value at the time of kidney biopsy for predicting future eGFR decline of ≥30% or ESKD was 7.7.

BACKGROUND

The Cardio-Ankle Vascular Index (CAVI) is a noninvasive index of arterial stiffness that is independent of BP at the time of measurement. Although the role of CAVI as a predictor of cardiovascular events has been reported, few studies have considered kidney prognosis. This study investigated the association between CAVI and long-term kidney prognosis in patients with nondiabetic CKD who underwent kidney biopsy.

METHODS

This study was a longitudinal, observational, single-center study of patients with CKD stages 1–4 and follow-up ≥1 year who had CAVI measured at the time of kidney biopsy. The primary outcome was a 30% decline in the eGFR from baseline or ESKD.

RESULTS

Forty-six patients (mean age, 53 years; median eGFR, 61.5 ml/min per 1.73 m; median follow-up period, 98 months) were enrolled. Eighteen patients achieved the primary outcome and a higher CAVI was significantly associated with this outcome. Multivariate analyses consistently identified CAVI as an independent factor associated with the outcome. Using receiver-operating characteristic curve analysis, the cutoff value for CAVI was 7.7 (sensitivity, 78%; specificity, 79%). Kaplan–Meier analysis showed significantly lower outcome-free survival in the CAVI ≥7.7 group than in the CAVI <7.7 group. No consistent trend was observed between kidney histopathology and CAVI.

CONCLUSIONS

CAVI at the time of kidney biopsy is independently associated with long-term kidney prognosis in patients with nondiabetic CKD.