Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12882-020-02024-z
Title: Aortic pulse wave velocity, central pulse pressure, augmentation index and chronic kidney disease progression in individuals with type 2 diabetes: A 3- year prospective study
Authors: Liu, J.-J.
Liu, S.
Lee, J.
Gurung, R.L.
Yiamunaa, M.
Ang, K.
Shao, Y.M.
Choo, R.W.M.
Tavintharan, S.
Tang, W.E.
Sum, C.F.
Lim, S.C. 
Keywords: Arterial stiffness
Central pulse pressure
Chronic kidney disease
Pulse wave velocity
Type 2 diabetes
Issue Date: 2020
Publisher: BioMed Central Ltd
Citation: Liu, J.-J., Liu, S., Lee, J., Gurung, R.L., Yiamunaa, M., Ang, K., Shao, Y.M., Choo, R.W.M., Tavintharan, S., Tang, W.E., Sum, C.F., Lim, S.C. (2020). Aortic pulse wave velocity, central pulse pressure, augmentation index and chronic kidney disease progression in individuals with type 2 diabetes: A 3- year prospective study. BMC Nephrology 21 (1) : 359. ScholarBank@NUS Repository. https://doi.org/10.1186/s12882-020-02024-z
Rights: Attribution 4.0 International
Abstract: Background: Pulse wave velocity (PWV), central pulse pressure and augmentation index are arterial stiffness- related hemodynamic parameters but their associations with renal outcome are still controversial. We hereby aim to study, 1) which hemodynamic parameter is independently associated with progressive chronic kidney disease (CKD), 2) the association of 3-year change in PWV with CKD progression and, 3) the additive predictive value of PWV for progressive CKD. Methods: Carotid- femoral PWV, central pulse pressure and augmentation index were measured in 1444 participants with type 2 diabetes at baseline and 3 years apart. Progressive CKD was defined as confirmed eGFR decline 40% or greater. Results: In the follow-up, 102 participants experienced progressive CKD. All 3 hemodynamic parameters were significantly associated with progressive CKD In univariable analysis. However, only PWV remained statistically significant after adjustment for known clinical risk factors and the other 2 hemodynamic parameters (OR 1.14 [95% CI 1.01-1.29] per m/s increment). One m/s regression (decrement) in PWV in the 3-year follow-up was associated with 26% lower adjusted- risk of progressive CKD (OR 0.74, 95% CI 0.56-0.97). Adding PWV onto traditional risk factor- based model significantly improved classification (net reclassification improvement 0.25, 95% CI 0.05-0.45, P = 0.01) and positive prediction rate (24.5 to 32.3%). Conclusions: Of 3 arterial stiffness- related hemodynamic parameters, only PWV is independently associated with progressive CKD. PWV may be a potential intervention target to mitigate risk of CKD progression and also a biomarker to improve risk-stratification of adverse renal outcome in individuals with type 2 diabetes. © 2020 The Author(s).
Source Title: BMC Nephrology
URI: https://scholarbank.nus.edu.sg/handle/10635/197595
ISSN: 14712369
DOI: 10.1186/s12882-020-02024-z
Rights: Attribution 4.0 International
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