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Journal of Hypertension:
doi: 10.1097/HJH.0000000000000113
ORIGINAL PAPERS: Blood vessels

Aortic pulse wave velocity predicts mortality in chronic kidney disease stages 2–4

Baumann, Marcusa; Wassertheurer, Siegfriedb; Suttmann, Yanaa; Burkhardt, Klausc; Heemann, Uwea

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Abstract

Background: Chronic kidney disease (CKD) is characterized by aortic stiffness and increased cardiovascular mortality. In end-stage renal disease, aortic stiffness predicts mortality, whereas this role remains uncertain in mild-to-moderate CKD. We aimed to investigate whether aortic pulse wave velocity (aPWV) predicts mortality and renal disease progression in CKD patients.

Methods: We enrolled 135 CKD patients stages 2–4 [estimated glomerular filtration rate (eGFR): 41.1 (28.5–61.6) ml/min per 1.73 m2] in the study and assessed aPWV. The combined renal end-point was defined as at least 50% decline in renal function and/or start of renal replacement therapy.

Results: During the observational period of 42 (30–50) months six patients were lost of follow-up, 13 patients died and 16 patients reached the combined renal end-point. Stratification according to the mean of aPWV (10 m/s), Kaplan–Meier analysis revealed increased mortality with aPWV ≥10 m/s (log-rank P < 0.05). Stepwise logistic regression analysis confirmed aPWV as an independent predictor for mortality in CKD stage 2–4. The hazard ratio of mortality in the cohort with an aPWV at least 10 m/s was 5.1 (1.1–22.9). By contrast, Kaplan–Meier analysis revealed no effect of aPWV on the combined renal end-point (log-rank P = 0.90).

Discussion: These results provide the first direct evidence that in patients with CKD stage 2–4, increased aortic stiffness determined by aPWV is a strong independent predictor of all-cause mortality.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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