Kidney Week

Abstract: FR-PO448

Significance of Cardio-Ankle Vascular Index in the Long-Term Renal Prognosis for Patients with Non-Diabetic CKD

Session Information

• CKD: Risk Factors for Incidence and Progression - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 301 CKD: Risk Factors for Incidence and Progression

Authors

• Shimizu, Akihiro, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Akihiro Shimizu,

• Okonogi, Hideo, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Hideo Okonogi,

• Kawamura, Tetsuya, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Tetsuya Kawamura,

• Yokote, Shinya, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Shinya Yokote,

• Suyama, Masahiro, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Masahiro Suyama,

• Matsumoto, Kei, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Kei Matsumoto,

• Koike, Kentaro, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Kentaro Koike,

• Tsuboi, Nobuo, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Nobuo Tsuboi,

• Miyazaki, Yoichi, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Yoichi Miyazaki,

• Ikeda, Masato, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Masato Ikeda,

• Ogura, Makoto, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Makoto Ogura,

• Yokoo, Takashi, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan

Takashi Yokoo,

Background

Cardio-ankle vascular index (CAVI) is a non-invasive index of arterial stiffness and, theoretically, independent of blood pressure at the time of measurement. Although the role of CAVI as a predictor of cardiovascular events has been reported, few studies have considered the renal prognosis. The present retrospective cohort study was undertaken to investigate the association between CAVI and the long-term renal prognosis in patients with non-diabetic chronic kidney disease (NDCKD).

Methods

We included 44 NDCKD patients (CKD stages 1, 2, 3 and 4, and follow-up period ≥2 years), who were diagnosed by first time renal biopsy (RBx). Renal outcome was defined as reaching 30% decline in eGFR from baseline. We analyzed the association between CAVI and outcome, and risk factors affecting the incidence of outcome, by Cox proportional hazard model, receiver-operating characteristic (ROC) analysis, and Kaplan–Meier analysis.

Results

As a result, a median follow-up time was 86 months (range, 27–101 months), and 15 patients reached outcome. Baseline CAVI, eGFR, hypertension and uric acid were significantly associated with outcome by univariate Cox analysis (p<0.05). By ROC analysis, the areas under the curve for diagnosis of the future outcome by baseline CAVI was 0.838 (p=0.0007), and CAVI cut-off value was calculated as 7.50 (Sensitivity 93%, Specificity 62%). Then CAVI≥7.5 (HCAVI) and eGFR were independently associated with outcome by multivariate Cox analysis, (Hazard ratio (HR) 7.3, 95% confidence interval (CI) 1.2-141, p<0.05, and HR 0.97, 95%CI 0.94-0.99, p<0.05, respectively). Furthermore, Kaplan-Meier analysis showed that outcome-free survival was significantly lower in HCAVI group compared with CAVI<7.5 group (Log-rank test, p=0.0017).

Conclusion

These results indicated that CAVI at the time of RBx was independently associated with long-term renal prognosis in NDCKD patients.